Clinicopathological characteristics of surgically treated localized renal masses in patients previously exposed to chemotherapy



Título del documento: Clinicopathological characteristics of surgically treated localized renal masses in patients previously exposed to chemotherapy
Revista: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000434813
ISSN: 1677-5538
Autors: 1
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Institucions: 1Duke University Medical Center, Division of Urology, Durham. Estados Unidos de América
Any:
Període: Mar-Abr
Volum: 45
Número: 2
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Purpose: To explore the potential association between renal mass characteristics and a history of chemotherapy. Materials and methods: A retrospective review of records of patients surgically treated for a localized renal mass between 2000 and 2012 was undertaken following an institutional review board approval. Patients age and sex, renal mass clinical characteristics (radiological size and mode of presentation) and pathological characteristics (diagnosis, renal cell carcinoma subtype, Fuhrman grade and stage) were compared between patients with and without a history of chemotherapy, using Fisher's exact test, Student's t-test and Wilcoxon rank sum test. A multivariate logistic analysis was performed to evaluate the independent association of chemotherapy and tumor pathology. Results: Of the 1,038 eligible patients, 33 (3%) had a history of chemotherapy. The distribution of clinical stage, renal mass diagnosis, renal cell carcinoma subtype, Fuhrman grade, pathological stage, sex and median age were similar between the general population and the chemotherapy group. However, the latter had a higher rate of incidental presentation (P = 0.003) and a significantly smaller median radiological tumor size (P = 0.01). In a subset analysis of T1a renal cell carcinoma, the chemotherapy group presented an increased rate of high Fuhrman grade (P = 0.03). On multivariate analysis adjusted for radiological tumor size, sex and age the chemotherapy cohort had a 3.92 higher odds for high Fuhrman grade. Conclusion: Patients with a history of chemotherapy typically present with smaller renal masses that, if malignant, have higher odds of harboring a high Fuhrman grade and thus may not be suitable for active surveillance
Disciplines Medicina
Paraules clau: Oncología,
Nefrología,
Carcinoma de células renales,
Quimioterapia,
Perfusión regional,
Resección quirúrgica
Keyword: Oncology,
Nephrology,
Renal cells carcinoma,
Chemotherapy,
Regional perfusion,
Surgical resection
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