MP59-07 PATIENTS WITH ANATOMICALLY “SIMPLE” RENAL MASSES ARE MORE LIKELY TO BE PLACED ON ACTIVE SURVEILLANCE THAN THOSE WITH ANATOMICALLY “COMPLEX” LESIONS (2014)

You have accessJournal of UrologyKidney Cancer: Localized IV1 Apr 2014MP59-07 PATIENTS WITH ANATOMICALLY “SIMPLE” RENAL MASSES ARE MORE LIKELY TO BE PLACED ON ACTIVE SURVEILLANCE THAN THOSE WITH ANATOMICALLY “COMPLEX” LESIONS Jeffrey Tomaszewski, Robert Uzzo, Neil Kocher, Brandon Manley, Tianyu Li, Reza Mehrazin, Timothy Ito, Phil Abbosh, Rosalia Viterbo, David Chen, Richard Greenberg, Marc Smaldone, and Alexander Kutikov Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author , Robert UzzoRobert Uzzo More articles by this author , Neil KocherNeil Kocher More articles by this author , Brandon ManleyBrandon Manley More articles by this author , Tianyu LiTianyu Li More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Timothy ItoTimothy Ito More articles by this author , Phil AbboshPhil Abbosh More articles by this author , Rosalia ViterboRosalia Viterbo More articles by this author , David ChenDavid Chen More articles by this author , Richard GreenbergRichard Greenberg More articles by this author , Marc SmaldoneMarc Smaldone More articles by this author , and Alexander KutikovAlexander Kutikov More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1803AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Clinical decision-making for patients with a renal mass is at least in part extremely subjective. We hypothesized that renal masses with low anatomic complexity on imaging are deemed clinically less "worrisome" and therefore are more likely to be considered for active surveillance (AS). Methods We queried our prospective institutional database to identify and compare patients with stage I localized RCC undergoing an initial period of AS or immediate surgery. Multivariate logistic regression was used to examine covariates associated with receipt of AS. Results Of 1059 patients identified, 195 patients (mean age 65±13 years) underwent an initial period of AS (mean duration of AS 34.8±28.5 months). Compared to patients undergoing immediate surgical treatment (n=864), patients selected for AS had lower overall Nephrometry scores (mean score 5.5 vs. 6.1; p<0.001), and were smaller, further from the sinus or urothelium, more often polar and less often hilar (p<0.0015 all comparisons). After adjustment for age, largest tumor size, individual components of NS, total NS, and CCI, total NS (OR 1.9 [CI 1.4-2.5]), “R” score of 1 (OR 5.2 [CI 1.8-15.2]), “N” score of 1 (OR 10.6 [CI 4.2-26.8]), “L” score of 1 (OR 5.2 [CI 2.3-11.8]), and non-hilar tumor location (OR 2.4 [CI 1.1-5.3]) increased the probability of being selected for AS compared to immediate surgery. Findings remained significant in a sub-analysis of T1a renal masses. Conclusions Tumor anatomic complexity was strongly associated with the decision to proceed with active surveillance in patients with Stage I renal mass. Not only may these data help better understand and follow renal mass treatment trends, but the findings may also prove useful in development of objective protocols to most appropriately select patients for Active Surveillance. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e652 Advertisement Copyright & Permissions© 2014Metrics Author Information Jeffrey Tomaszewski More articles by this author Robert Uzzo More articles by this author Neil Kocher More articles by this author Brandon Manley More articles by this author Tianyu Li More articles by this author Reza Mehrazin More articles by this author Timothy Ito More articles by this author Phil Abbosh More articles by this author Rosalia Viterbo More articles by this author David Chen More articles by this author Richard Greenberg More articles by this author Marc Smaldone More articles by this author Alexander Kutikov More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...