Clinical outcome of incidentally discovered small renal cell carcinoma after delayed surgery

Abstract

Koichi Sugimoto,1,2 Nobutaka Shimizu,1 Takashi Oki,2 Kazuhiro Nose,2 Tsukasa Nishioka,2 Shogo Adomi,3 Takayuki Ohzeki,3 Atsunobu Esa,3 Hirotsugu Uemura11Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; 2Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osaka, Japan; 3Department of Urology, NTT West Osaka Hospital, Osaka, Osaka, JapanBackground: This study was undertaken to investigate the growth rate and clinical outcome of patients with a small renal mass (SRM) after delayed surgery.Methods: We reviewed the clinical records of 34 patients with SRMs ≦ 4 cm at diagnosis, who underwent delayed surgical intervention during surveillance from January 2000 to December 2011. Radiographic evaluations using computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed at least every 6 months, and the tumor size was determined at least twice.Results: The mean follow-up time was 26.6 ± 18.6 months and mean tumor doubling time was 23.4 ± 16.0 months. Histopathological analysis revealed that 32 of the 34 patients were malignant in pT1aN0M0. Only one patient showed tumor recurrence, who subsequently died due to tumor progression.Conclusion: The growth rate of the small renal mass was slow in the majority of our patients. Delayed intervention does not have a detrimental effect on cancer-specific outcomes.Keywords: renal cell carcinoma, small renal mass, natural history, growth rate, delayed intervention