Sangjun Yoo1, Dalsan You2, Cheryn Song2, Bumsik Hong2, Jun Hyuk Hong2, Choung-Soo Kim2, Hanjong Ahn2, In Gab Jeong3. 1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea. 2. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: igjeong@amc.seoul.kr.
Abstract
PURPOSE: We evaluated the changes in the incidence of benign lesions in surgically removed small renal masses (SRMs) and the effect of diagnostic tests for characterizing SRMs. METHODS: We included 2,707 patients receiving surgery for SRMs (<4cm). Trends in the incidence of benign histology were evaluated according to the surgery year (period 1: 2001-2005, 2: 2006-2010, and 3: 2011-2015). Multivariable logistic regression analysis was performed to identify factors associated with benign lesions. Additionally, the number of surgeries prevented due to benign histological findings on renal mass biopsies (RMB) done on 206 patients with SRM during study period was evaluated. RESULTS: Benign histology was identified in 192 (7.1%) patients. Incidence of benign histology was 9.7%, 7.0%, and 6.3% for period 1, 2 and 3, respectively. The uses of multiphase computed tomography and magnetic resonance imaging were more common in periods 2 and 3 than in period 1 (P<0.001). The use of RMB in period 3 was higher than in periods 1 and 2 (0.8 vs. 0.9 vs. 9.0%, P<0.001). In multivariable analysis, older age, male sex, larger tumor size, and recent surgery year (period 3 vs. 1, odds ratio = 0.62, P = 0.028) were independently associated with decreased odds of benign lesions. The number of prevented surgeries by performing RMB was 0, 10, and 39 in periods 1, 2, and 3, respectively. CONCLUSIONS: Incidence of benign histology after surgery for SRMs declined during recent years, which might be associated with the recent increased use of RMB.
PURPOSE: We evaluated the changes in the incidence of benign lesions in surgically removed small renal masses (SRMs) and the effect of diagnostic tests for characterizing SRMs. METHODS: We included 2,707 patients receiving surgery for SRMs (<4cm). Trends in the incidence of benign histology were evaluated according to the surgery year (period 1: 2001-2005, 2: 2006-2010, and 3: 2011-2015). Multivariable logistic regression analysis was performed to identify factors associated with benign lesions. Additionally, the number of surgeries prevented due to benign histological findings on renal mass biopsies (RMB) done on 206 patients with SRM during study period was evaluated. RESULTS: Benign histology was identified in 192 (7.1%) patients. Incidence of benign histology was 9.7%, 7.0%, and 6.3% for period 1, 2 and 3, respectively. The uses of multiphase computed tomography and magnetic resonance imaging were more common in periods 2 and 3 than in period 1 (P<0.001). The use of RMB in period 3 was higher than in periods 1 and 2 (0.8 vs. 0.9 vs. 9.0%, P<0.001). In multivariable analysis, older age, male sex, larger tumor size, and recent surgery year (period 3 vs. 1, odds ratio = 0.62, P = 0.028) were independently associated with decreased odds of benign lesions. The number of prevented surgeries by performing RMB was 0, 10, and 39 in periods 1, 2, and 3, respectively. CONCLUSIONS: Incidence of benign histology after surgery for SRMs declined during recent years, which might be associated with the recent increased use of RMB.