Benefit and Harm of Active Surveillance for Biopsy-proven Renal Oncocytoma : A Systematic Review and Pooled Analysis
Baboudjian, Michael (Fundació Puigvert)
Moser, D. (Department of Urology. Comprehensive Cancer Center. Medical University of Vienna)
Yanagisawa, T. (Department of Urology. The Jikei University School of Medicine)
Gondran-Tellier, B. (Department of Urology and Kidney Transplantation. Aix-Marseille University. APHM. Conception University Hospital)
Compérat, Eva (Department of Pathology. Medical University of Vienna)
Ambrosetti, D. (Department of Pathology. CHU Nice. University of Côte d'Azur)
Daniel, L. (Department of Pathology. Aix-Marseille University. APHM. La Timone University Hospital)
Bastide, C. (Department of Urology. Aix-Marseille University. APHM. North University Hospital)
Shariat, S.F. (Department of Urology. Comprehensive Cancer Center. Medical University of Vienna)
Lechevallier, E. (Department of Urology and Kidney Transplantation. Aix-Marseille University. APHM. Conception University Hospital)
Diana, Pietro (Fundació Puigvert)
Breda, Alberto (Institut d'Investigació Biomèdica Sant Pau)
Pradere, B. (Department of Urology. Comprehensive Cancer Center. Medical University of Vienna)
Boissier, Romain (Department of Urology and Kidney Transplantation. Aix-Marseille University. APHM. Conception University Hospital)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Context: Active surveillance (AS) of biopsy-proven renal oncocytomas may reduce overtreatment. However, on biopsy, the risk of misdiagnosis owing principally to entities with peculiar hybrids and overlap morphology, and phenotypes argues for early intervention. Objective: To assess the benefit and harm of AS in biopsy-proven renal oncocytoma. Evidence acquisition: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We systematically searched PubMed, Scopus, and Web of Science databases from September 26 up to October 2021, for studies that analyzed the outcomes of AS in patients with biopsy-proven renal oncocytoma. Evidence synthesis: A total of ten studies with 633 patients met our inclusion criteria and were included for analysis. After a median follow-up of 34. 5 mo (95% confidence interval [CI] 30. 6-38. 4), the overall definitive treatment rate from AS to definitive treatment was 17. 3% (n = 75/433, six studies). The pooled pathological agreement between the initial renal mass biopsy and the surgical pathology report was 91. 1%. The main indications for surgery during follow-up were rapid tumor growth and patient request. The pooled median growth rate was 1. 55 mm/yr (95% CI 0. 9-2. 2). No metastasis or death related to renal oncocytoma was reported. Conclusions: Annual tumor growth of biopsy-proven renal oncocytoma is low. AS is oncologically safe, with favorable compliance of patients. Crossover to definitive treatment revealed a strong concordance between biopsy and final pathology. Further studies on the long-term outcomes of AS are needed. Patient summary: In this study, we examined the benefit and harm of active surveillance (AS) in biopsy-proven oncocytoma. Based on the available data, AS appears oncologically safe and may represent a promising alternative to immediate treatment. Patients should be included in AS decision discussions.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Subject:	Oncocytoma ; Renal ; Biopsy ; Surveillance ; Review
Published in:	European Urology Open Science, Vol. 41 (july 2022) , p. 8-15, ISSN 2666-1683

DOI: 10.1016/j.euros.2022.04.009
PMID: 35633831

8 p, 1.3 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles