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Clinical Outcome of Small Renal Cell Carcinoma after Delayed Surgery versus Immediate Surgery
Koichi Sugimoto1, Nobutaka Shimizu, Kazuhiro Nose
11. Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; ; 2. Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osaka, Japan;
Background:
This study was undertaken to investigate the growth rate and clinical outcome of patients with a small renal mass (SRM) after delayed surgery versus immediate surgery.
Methods:
We reviewed the clinical records of 328 patients with SRM ≦ 4cm at diagnosis, who underwent delayed or immediate surgical intervention from January 2000 to December 2011. Radiographic evaluation using CT scan and MRI were performed at least every 6 months and the tumor size was determined at least twice in the delayed surgery group.
Results:
A total of 292 RCC patients with pT1aN0M0 were identified; among them, 32 patients had been managed with delayed surgery intervention. No statistically significant difference was observed in overall survival rate (OSR) and cancer recurrence-free rate (CRFR). But cancer-specific survival rate (CSSR) was significantly lower in the delayed surgery group (p=0.0002).
Conclusions:
The overall survival rate of delayed surgery was not inferior compared with that after immediate surgery. Delayed surgery intervention for SRMs is a treatment option in the current study.
Insights
For small renal masses (SRMs), delayed surgery showed similar overall survival rates compared to immediate surgery. However, cancer-specific survival rates were lower in the delayed surgery group, indicating a need for careful patient selection.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Small renal masses (SRMs) management involves active surveillance or intervention.
- Evaluating clinical outcomes for delayed versus immediate surgical intervention in SRMs is crucial.
Purpose of the Study:
- To compare the growth rate and clinical outcomes of small renal masses (SRMs) treated with delayed versus immediate surgery.
- To assess the impact of surgical timing on survival and recurrence rates in SRM patients.
Main Methods:
- Retrospective review of 328 patients diagnosed with SRM ≤ 4cm between 2000-2011.
- Analysis of radiographic data (CT/MRI) for tumor size and clinical outcomes in delayed vs. immediate surgery groups.
Main Results:
- 292 Renal Cell Carcinoma (RCC) patients with pT1aN0M0 were identified; 32 underwent delayed surgery.
- No significant difference in Overall Survival Rate (OSR) or Cancer Recurrence-Free Rate (CRFR) between groups.
- Cancer-Specific Survival Rate (CSSR) was significantly lower in the delayed surgery group (p=0.0002).
Conclusions:
- Delayed surgery for SRMs is a viable treatment option, with overall survival not inferior to immediate surgery.
- While overall survival is comparable, the lower CSSR in the delayed group suggests careful consideration for patient selection and monitoring.
