BMC Urology (Jul 2020)

Small renal masses in Latin-American population: characteristics and prognostic factors for survival, recurrence and metastasis – a multi-institutional study from LARCG database

  • Thiago Camelo Mourão,
  • Diego Abreu,
  • Gustavo F. Carvalhal,
  • Guillermo Gueglio,
  • Walter H. da Costa,
  • Vinicius Fernando Calsavara,
  • Luis Meza-Montoya,
  • Rubén G. Bengió,
  • Carlos Scorticati,
  • Ricardo Castillejos-Molina,
  • Francisco Rodríguez-Covarrubias,
  • Ana María Autran-Gómez,
  • José Gadu Campos-Salcedo,
  • Alejandro Nolazco,
  • Carlos Ameri,
  • Hamilton Zampolli,
  • Raúl Langenhin,
  • Diego Muguruza,
  • Marcos Tobias Machado,
  • Pablo Mingote,
  • Jorge Clavijo,
  • Lucas Nogueira,
  • Omar Clark,
  • Agustín R. Rovegno,
  • Fernando P. Secin,
  • Ricardo Decia,
  • Gustavo C. Guimarães,
  • Sidney Glina,
  • Oscar Rodríguez-Faba,
  • Joan Palou,
  • Stenio C. Zequi

DOI
https://doi.org/10.1186/s12894-020-00649-8
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 9

Abstract

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Abstract Background 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. Methods 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. Results 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. Conclusions 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.

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