Benefit and Harm of Active Surveillance for Biopsy-proven Renal Oncocytoma: A Systematic Review and Pooled Analysis
Por:
Baboudjian, M, Moser, D, Yanagisawa, T, Gondran-Tellier, B, Comperat, EM, Ambrosetti, D, Daniel, L, Bastide, C, Shariat, SF, Lechevallier, E, Diana, P, Breda, A, Pradere, B, Boissier, R
Publicada:
1 jul 2022
Ahead of Print:
1 may 2022
Resumen:
Context: Active surveillance (AS) of biopsy-proven renal oncocytomas may reduce overtreatment. However, on biopsy, the risk of misdiagnosis owing principally to entities with peculiar hybrids and overlap morphology, and phenotypes argues for early intervention.
Objective: To assess the benefit and harm of AS in biopsy-proven renal oncocytoma.
Evidence acquisition: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We systematically searched PubMed, Scopus, and Web of Science databases from September 26 up to October 2021, for studies that analyzed the outcomes of AS in patients with biopsy-proven renal oncocytoma.
Evidence synthesis: A total of ten studies with 633 patients met our inclusion criteria and were included for analysis. After a median follow-up of 34.5 mo (95% confidence interval [CI] 30.6-38.4), the overall definitive treatment rate from AS to definitive treatment was 17.3% (n = 75/433, six studies). The pooled pathological agreement between the initial renal mass biopsy and the surgical pathology report was 91.1%. The main indications for surgery during follow-up were rapid tumor growth and patient request. The pooled median growth rate was 1.55 mm/yr (95% CI 0.9-2.2). No metastasis or death related to renal oncocytoma was reported.
Conclusions: Annual tumor growth of biopsy-proven renal oncocytoma is low. AS is oncologically safe, with favorable compliance of patients. Crossover to definitive treatment revealed a strong concordance between biopsy and final pathology. Further studies on the long-term outcomes of AS are needed.
Patient summary: In this study, we examined the benefit and harm of active surveillance (AS) in biopsy-proven oncocytoma. Based on the available data, AS appears oncologically safe and may represent a promising alternative to immediate treatment. Patients should be included in AS decision discussions. (C) 2022 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.
Filiaciones:
Baboudjian, M:
Aix Marseille Univ, Concept Univ Hosp, AP HM, Dept Urol & Kidney Transplantat, 147 Blvd Baille, F-13005 Marseille, France
Aix Marseille Univ, North Univ Hosp, AP HM, Dept Urol, Marseille, France
Autonoma Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Moser, D:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Yanagisawa, T:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Jikei Univ, Dept Urol, Sch Med, Tokyo, Japan
Gondran-Tellier, B:
Aix Marseille Univ, Concept Univ Hosp, AP HM, Dept Urol & Kidney Transplantat, 147 Blvd Baille, F-13005 Marseille, France
Comperat, EM:
Med Univ Vienna, Dept Pathol, Vienna, Austria
Ambrosetti, D:
Univ Cote dAzur, Dept Pathol, CHU Nice, Nice, France
Daniel, L:
Aix Marseille Univ, La Timone Univ Hosp, AP HM, Dept Pathol, Marseille, France
Bastide, C:
Aix Marseille Univ, North Univ Hosp, AP HM, Dept Urol, Marseille, France
Shariat, SF:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Lechevallier, E:
Aix Marseille Univ, Concept Univ Hosp, AP HM, Dept Urol & Kidney Transplantat, 147 Blvd Baille, F-13005 Marseille, France
Diana, P:
Autonoma Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Breda, A:
Autonoma Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Pradere, B:
Med Univ Vienna, Comprehens Canc Ctr, Dept Urol, Vienna, Austria
Boissier, R:
Aix Marseille Univ, Concept Univ Hosp, AP HM, Dept Urol & Kidney Transplantat, 147 Blvd Baille, F-13005 Marseille, France
gold, Green Published
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