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In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
Predicting growth of solid renal masses under active surveillance
Paul L Crispen1, Yu-Ning Wong, Richard E Greenberg
1Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Urologic Oncology
|September 9, 2008
Summary
Active surveillance of solid enhancing renal tumors shows growth rates are not predicted by patient or tumor characteristics. While short-term progression risk is low, better clinical and molecular markers are needed for active surveillance decisions.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Active surveillance is used to monitor solid enhancing renal tumors in patients unsuitable for surgery.
- Serial radiographic evaluation aids in characterizing tumor growth in untreated renal masses.
Purpose of the Study:
- To identify factors that predict radiographic growth of untreated enhancing renal tumors during active surveillance.
- To characterize the natural history and growth rates of these tumors.
Main Methods:
- Review of a renal cancer database for enhancing renal masses observed for at least 12 months.
- Analysis of patient demographics, lesion size, tumor characteristics, surveillance duration, growth rate, pathology, and disease progression.
Main Results:
- 124 tumors in 109 patients were analyzed; median surveillance was 26 months.
- Tumor growth rates were independent of patient age, gender, initial size, multifocality, and radiographic features (P > 0.05).
- 36% of patients eventually underwent treatment, with 90% showing malignant pathology; low rates of new lesions or metastasis were observed in those continuing surveillance.
Conclusions:
- No current clinical predictors for tumor growth or disease progression in enhancing renal tumors under active surveillance.
- The short-term risk of progressive disease appears low.
- Development of clinical and molecular markers is crucial for refining active surveillance candidacy.
