Histopathologic features and parameters predicting recurrence potential of small renal masses

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Small renal masses (SRMs) are defined as contrast-enhanced masses ≤4 cm, often T1a renal cell carcinoma (RCC).
• Understanding SRM histopathology is crucial for predicting clinical behavior.
• This study investigated pathological features, metastatic potential, and recurrence risk in SRMs.

Purpose of the Study:

• To explore histopathological features of contemporary SRMs.
• To identify predictors of pathological nature, metastatic potential, and recurrence.
• To analyze factors influencing tumor recurrence in SRMs.

Main Methods:

• Retrospective analysis of 166 patients undergoing surgery for suspected SRMs.
• Comparison of radical vs. partial nephrectomy (1:44 ratio).
• Statistical analysis (chi-squared, logistic regression) of variables associated with metastatic recurrence.

Main Results:

• 86% of SRMs were malignant (RCC), 14% benign. 17% of RCCs were high-grade (G3-4).
• Malignant SRMs were larger (31 ± 8 mm vs. 24 ± 9 mm) and occurred in older patients.
• Tumor size, grade, stage, metastasis, localization, and treatment modality predicted recurrence.

Conclusions:

• Malignant neoplasms were the majority of treated SRMs, but less common in masses <2 cm.
• Histopathological features and treatment modalities are key to predicting malignant recurrence in SRMs.