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Analysis of renal tumor size as a pbkp_redictive factor of oncological aggressiveness

Abstract:

INTRODUCTION: The increased incidence of diagnosis of kidney tumours has driven investigation in the area. It is known that the risk of malignancy is correlated with tumour size, but there are still no specific and objective parameters to characterize the degree of aggressiveness and to be able to guide a treatment reliably. OBJECTIVE: To identify the relationship between renal tumour size and the incidence of tumour aggressive characteristics. PATIENTS AND METHODS: A retrospective analysis of our series of renal cancers operated between 1998 and 2018 was performed. The specific and cumulative incidence of aggressive characteristics was studied. The following where considered as aggressive characteristics: Presence of sarcomatoid or epidermoid differentiation, tumour necrosis, stage pT3-4, histological high grade (3-4) and the presence of histological aggressive variants. RESULTS: A total of 651 patients that had undergone renal mass surgery were analysed. In tumours below 2 cm the appearance of aggressive characteristics occurred in less than 5%. For renal masses greater than 2 cm, each centimetre increase correlated with a rise in cumulative incidence of 2-3% for each characteristic studied. CONCLUSIONS: In tumours below 2cm and patients with significant comorbidities active surveillance may be a reliable alternative to surgery.