[Incidental kidney neoplasm: anatomopathologic characteristics and clinical behavior]

Area of Science:

• Urology
• Oncology
• Radiology

Background:

• Increased use of abdominal ultrasound and CT scans leads to more incidental kidney tumor discoveries.
• Kidney tumors are increasingly found by chance during imaging for non-renal conditions.
• Understanding the characteristics and outcomes of incidentally discovered kidney tumors is crucial.

Purpose of the Study:

• To compare anatomopathological features of incidentally discovered kidney tumors (incidentalomas) versus symptomatic kidney tumors.
• To evaluate the clinical evolution and overall survival rates between these two groups.
• To determine if incidental discovery impacts patient prognosis.

Main Methods:

• Retrospective analysis of 338 patients who underwent radical nephrectomy between 1979 and 1999.
• Patients were divided into two groups: symptomatic tumors (Group 1) and incidentalomas (Group 2).
• Key parameters analyzed included histological type, pathological stage, Fuhrman's grade, tumor diameter, and overall survival.

Main Results:

• Incidentalomas (Group 2) showed a higher incidence of stage T1 tumors (42.1%) compared to symptomatic tumors (Group 1) (29.4%).
• Advanced tumor stages were more frequent in the symptomatic group (15.6%) than in the incidentaloma group (9%).
• Patients with incidentalomas had significantly longer overall survival (13.5% deaths) compared to symptomatic patients (23.1% deaths) (p < 0.03).

Conclusions:

• Kidney tumors discovered incidentally are associated with significantly better overall survival.
• This improved survival is attributed to incidentalomas being detected at an earlier pathological stage and smaller size.
• Routine imaging for non-renal conditions aids in early detection and improved outcomes for kidney cancer patients.