A Preoperative Prognostic Nomogram for Solid Enhancing Renal Tumors 7 cm or Less Amenable to Partial Nephrectomy

作者：Brian R. Lane, Denise C. Babineau, Michael W. Kattan, Andrew C. Novick, Inderbir Singh Gill, Ming Zhou, Christopher Weight, Steven C. Campbell · 发表于：The Journal of Urology · 年份：2007 · DOI：10.1016/j.juro.2007.03.106 · 被引用次数：256 · 研究领域：Renal cell carcinoma treatment、Renal and related cancers、Bladder and Urothelial Cancer Treatments

PURPOSE: Small renal masses are increasing in incidence. Most tumors 7 cm or less are treated with radical or partial nephrectomy but clinicians are increasingly relying on ablative therapies and observation for some small renal masses. We present novel nomograms that predict the likelihood of benign, likely indolent or potentially aggressive pathological findings based only on readily identifiable preoperative factors. MATERIALS AND METHODS: Information on all partial nephrectomies performed at a single institution was collected in an institutional review board approved registry. Using retrospectively collected data on all 862 patients who underwent partial nephrectomy for a single, solid, enhancing, clinical T1 (7 cm or less) tumor between 1999 and 2005 tumors were classified as benign or malignant. Grade 3 clear cell renal cell carcinoma, grade 4 renal cell carcinoma of any type and any renal cell carcinoma with vascular, fat or collecting system invasion were considered potentially aggressive. The likelihood of benign, likely indolent or potentially aggressive pathological findings was modeled using multivariable logistic regression models based on age, gender, radiographic tumor size, symptoms at presentation and smoking history. RESULTS: Of 862 small renal masses 20% were benign and 80% were malignant but only 30% of cancers (24% of small renal masses) were potentially aggressive. All 11 patients with systemic symptoms had cancer. The remaining 851 patients underwent fu...