Small renal masses in Latin-American population : Characteristics and prognostic factors for survival, recurrence and metastasis - A multi-institutional study from LARCG database
Mourão, T.C. (A.C. Camargo Cancer Center)
Abreu, Diego (Pasteur Hospital)
Carvalhal, Gustavo Franco (São Lucas Hospital - PUCRS)
Gueglio, Guillermo M. (Italian Hospital)
da Costa, Walter Henriques (A.C. Camargo Cancer Center)
Calsavara, Vinicius Fernando (A.C.Camargo Cancer Center)
Meza-Montoya, Luis (Instituto Nacional de Enfermedades Neoplásicas)
Bengió, Rúben Guillermo (Urological Center Profesor Bengió)
Scorticati, Carlos H. (Clinics Hospital José de San Martín)
Castillejos-Molina, Ricardo Alonso (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCNSZ))
Rodriguez-Covarrubias, Francisco (Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCNSZ))
Autran Gómez, Ana María (Hospital Universitario Fundación Jiménez Díaz)
Campos-Salcedo, José Gadú (Military Hospital)
Nolazco, Alejandro (Hospital Británico de Buenos Aires)
Ameri, Carlos Alberto (Hospital Alemán (Buenos Aires))
Zampolli, Hamilton De Campos (Instituto Arnaldo Vieira de Carvalho)
Langenhin, Raúl (Corporación Médica de Paysandú (COMEPA))
Muguruza, Diego (Corporación Médica de Paysandú (COMEPA))
Tobias-Machado, Marcos (ABC Medical School)
Mingote, Pablo (Policlínico Neuquén)
Clavijo, Jorge (Clinics Hospital)
Nogueira, Lucas Mendes (Federal University of Minas Gerais)
Clark, Omar (Military Hospital)
Rovegno, Agustín Roberto (Centro de Educación Médica e Investigaciones Clínicas (CEMIC))
Secín, Fernando Pablo (San Lázaro Foundation and FUNDES)
Decia, Ricardo (Hospital Pasteur Montevideo)
Cardoso Guimarães, Gustavo (Surgical Oncology Coordinator at Beneficencia Portuguesa Hospital)
Glina, Sidney (Ipiranga Hospital)
Rodríguez Faba, Óscar (Institut d'Investigació Biomèdica Sant Pau)
Palou, Juan (Institut d'Investigació Biomèdica Sant Pau)
Zequi, Stênio de Cássio (AC Camargo Cancer Center)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48. 5% (1979-2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (≥ 65 years) had better 10-year OS rates when submitted to PN (83. 5%), than RN (54. 5%), p = 0. 044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification ≥3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine.
Derechos:	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.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Kidney cancer ; Latin America ; Nephrectomy ; Nephron-sparing surgery ; Renal cell carcinoma
Publicado en:	BMC Urology, Vol. 20 Núm. 1 (february 2020) , p. 85, ISSN 1471-2490

DOI: 10.1186/s12894-020-00649-8
PMID: 32615971

9 p, 891.1 KB

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