Francois-Xavier Deledalle1, Damien Ambrosetti2, Mathieu Durand3, Floriane Michel4, Michael Baboudjian4, Bastien Gondran-Tellier4, François Lannes5, Laurent Daniel6, Marc André7, Pierre-Olivier Fais8, Pierre-Henri Savoie1, Xavier Durand9, Dominique Rossi5, Gilles Karsenty4, Cyrille Bastide5, Eric Lechevallier4, Romain Boissier10. 1. Department of Urology, Military Hospital Sainte-Anne, Toulon, France. 2. Department of Pathology, Nice University, Pasteur University Hospital, Nice, France. 3. Department of Urology, Nice University, Pasteur University Hospital, Nice, France. 4. Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France. 5. Department of Urology, Aix-Marseille University, APHM, Nord University Hospital, Marseille, France. 6. Department of Pathology, Aix-Marseille University, APHM, La Timone University Hospital, Marseille, France. 7. Department of Radiology, Aix-Marseille University, APHM, La Conception University Hospital, Marseille, France. 8. Department of Urology, Hospital Sainte-Musse, Toulon, France. 9. Department of Urology, Military Hospital Bégin, Saint Mandé, France. 10. Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France. Electronic address: romain.boissier@ap-hm.fr.
Abstract
OBJECTIVES: To report the outcomes and feasibility of active surveillance (AS) of biopsy-proven renal oncocytomas. METHODS: Multicentric retrospective study (2010-2016) in 6 academic centers that included patients with biopsy-proven renal oncocytomas who were allocated to AS (imperative or elective indication) with a follow-up ≥1 year. Imaging was performed at least once a year, by CT-scan or ultrasound or MRI. Conversion to active treatment (surgical excision or ablative treatment) was at the discretion of the urologist. The primary endpoint was renal tumor growth (cm/year). Secondary outcomes included accuracy of biopsy, incidence, and reason to change AS to active treatment. RESULTS: Eighty-nine patients were included: Median age 67 years (26-89) and median tumor size 26 mm [15-90] on diagnosis. During a mean follow-up of 43 months'' (median 36 [12-180]), mean tumor growth was 0.24 cm/year. No predictive factors (demographical, radiological or histologic) of tumor growth could be identified. Conversion from AS to active treatment occurred in 24 patients (27%) (13 surgical excisions, 11 ablative procedures), in a median time of 45 (12-76) months'' after diagnosis. Tumor growth was the main indication to convert AS to active treatment (58%) with 8% of the patients opting to discontinue AS. No patient had metastatic progression nor disease-specific death. The correlation between biopsy and surgical specimen was 92%. CONCLUSION: Active surveillance for biopsy-proven renal oncocytomas was oncologically safe and patient adherence was high. No predictive factor for tumor growth could be identified but the tumor growth rate was low, and biopsy efficacy was high.
OBJECTIVES: To report the outcomes and feasibility of active surveillance (AS) of biopsy-proven renal oncocytomas. METHODS: Multicentric retrospective study (2010-2016) in 6 academic centers that included patients with biopsy-proven renal oncocytomas who were allocated to AS (imperative or elective indication) with a follow-up ≥1 year. Imaging was performed at least once a year, by CT-scan or ultrasound or MRI. Conversion to active treatment (surgical excision or ablative treatment) was at the discretion of the urologist. The primary endpoint was renal tumor growth (cm/year). Secondary outcomes included accuracy of biopsy, incidence, and reason to change AS to active treatment. RESULTS: Eighty-nine patients were included: Median age 67 years (26-89) and median tumor size 26 mm [15-90] on diagnosis. During a mean follow-up of 43 months'' (median 36 [12-180]), mean tumor growth was 0.24 cm/year. No predictive factors (demographical, radiological or histologic) of tumor growth could be identified. Conversion from AS to active treatment occurred in 24 patients (27%) (13 surgical excisions, 11 ablative procedures), in a median time of 45 (12-76) months'' after diagnosis. Tumor growth was the main indication to convert AS to active treatment (58%) with 8% of the patients opting to discontinue AS. No patient had metastatic progression nor disease-specific death. The correlation between biopsy and surgical specimen was 92%. CONCLUSION: Active surveillance for biopsy-proven renal oncocytomas was oncologically safe and patient adherence was high. No predictive factor for tumor growth could be identified but the tumor growth rate was low, and biopsy efficacy was high.
Authors: Michael Baboudjian; Daniel Moser; Takafumi Yanagisawa; Bastien Gondran-Tellier; Eva M Compérat; Damien Ambrosetti; Laurent Daniel; Cyrille Bastide; Shahrokh F Shariat; Eric Lechevallier; Pietro Diana; Alberto Breda; Benjamin Pradere; Romain Boissier Journal: Eur Urol Open Sci Date: 2022-05-19