1996 AGE AND GENDER PREDICTS RISK OF NON-LOCALIZED DISEASE IN SMALL RENAL TUMORS ≤3CM IN SIZE IN THE UNITED STATES FROM 1988–2007статья из журнала
Аннотация: You have accessJournal of UrologyKidney Cancer: Advanced1 Apr 20111996 AGE AND GENDER PREDICTS RISK OF NON-LOCALIZED DISEASE IN SMALL RENAL TUMORS ≤3CM IN SIZE IN THE UNITED STATES FROM 1988–2007 Max Kates, Ruslan Korets, Neda Sadeghi, Phillip Pierorazio, and James McKiernan Max KatesMax Kates New York, NY More articles by this author , Ruslan KoretsRuslan Korets New York, NY More articles by this author , Neda SadeghiNeda Sadeghi New York, NY More articles by this author , Phillip PierorazioPhillip Pierorazio Baltimore, MD More articles by this author , and James McKiernanJames McKiernan New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2223AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is thought that patients with small renal masses (SRMs) have a negligible risk of metastases. However, recent publications have shown there to be a significant burden of metastatic RCC (mRCC) even in masses ≤3cm. The aim of this study was to assess the prevalence and characteristics of mRCC in the US population with SRMs to help identify patients at risk for non-localized disease. METHODS Using the Surveillance, Epidemiology, and End Results (SEER) registry we identified 14,962 patients diagnosed between 1988-2007 with renal cell carcinoma (RCC) ≤3cm in size. Patients were separated by stage into metastatic, locally advanced, and localized disease. Differences in baseline characteristics amongst patients in these 3 groups were assessed. After controlling for age, sex, grade, tumor size, and year of surgery, a logistic regression analysis was performed to determine likelihood of having non-localized disease. RESULTS In the SEER cohort, 13,574 (90.7%) patients with RCC ≤3cm were diagnosed with localized disease, 938 (6.3%) patients had invasion beyond the kidney into regional lymph nodes or nearby organs, and 450 (3.0%) patients had distant metastasis. Patients with metastasis were older (65.9 years) compared to those with localized disease (59.5 years) (p<.001). The rate of metastatic disease was higher in patients with tumors 2.5–3.0cm (4.3%) compared with tumors <2.5cm (2.4%). Independent preoperative predictors of having more aggressive disease at diagnosis (locally advanced/metastatic) included older age, particularly age >70 (OR: 2.46; 95% CI: 2.06–2.92), male sex(OR: 1.50; 95% CI: 1.33–1.70), and tumor size >2.5 (OR: 1.41; 95% CI: 1.25–1.58). CONCLUSIONS A small subset (3%) of patients in the US with RCC ≤3cm have distant metastasis. Older patients, men, and those with tumors 2.5-3cm are more likely to present with regionally advanced and metastatic disease despite having a mass <3cm. As the incidence of SRMs is increasing and active surveillance protocols are becoming more commonplace, clinician's should be aware of characteristics associated with advanced disease. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e799 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Max Kates New York, NY More articles by this author Ruslan Korets New York, NY More articles by this author Neda Sadeghi New York, NY More articles by this author Phillip Pierorazio Baltimore, MD More articles by this author James McKiernan New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Год издания: 2011
Издательство: Lippincott Williams & Wilkins
Источник: The Journal of Urology
Ключевые слова: Renal cell carcinoma treatment, Renal and related cancers, Bladder and Urothelial Cancer Treatments
Открытый доступ: closed
Том: 185
Выпуск: 4S