Small renal masses in Latin-American population: characteristics and prognostic factors for survival, recurrence and metastasis - a multi-institutional study from LARCG database
Por:
Mourao, TC, Abreu, D, Carvalhal, GF, Gueglio, G, da Costa, WH, Calsavara, VF, Meza-Montoya, L, Bengio, RG, Scorticati, C, Castillejos-Molina, R, Rodriguez-Covarrubias, F, Autran-Gomez, AM, Campos-Salcedo, JG, Nolazco, A, Ameri, C, Zampolli, H, Langenhin, R, Muguruza, D, Machado, MT, Mingote, P, Clavijo, J, Nogueira, L, Clark, O, Rovegno, AR, Secin, FP, Decia, R, Guimaraes, GC, Glina, S, Rodriguez-Faba, O, Palou, J, Zequi, SC
Publicada:
2 jul 2020
Resumen:
Background To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (<= 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. Methods A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. Results PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48.5% (1979-2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (>= 65 years) had better 10-year OS rates when submitted to PN (83.5%), than RN (54.5%),p = 0.044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification >= 3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. Conclusions PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine.
Filiaciones:
Mourao, TC:
AC Camargo Canc Ctr, Rua Antonio Prudente 211, BR-01509010 Liberdade, SP, Brazil
Abreu, D:
Pasteur Hosp, Montevideo, Uruguay
Carvalhal, GF:
Pontificia Univ Catolica Rio Grande do Sul, Sao Lucas Hosp, Porto Alegre, RS, Brazil
Gueglio, G:
Italian Hosp, Buenos Aires, DF, Argentina
da Costa, WH:
AC Camargo Canc Ctr, Rua Antonio Prudente 211, BR-01509010 Liberdade, SP, Brazil
Calsavara, VF:
AC Camargo Canc Ctr, Epidemiol & Stat Dept, Int Res Ctr, Sao Paulo, Brazil
Meza-Montoya, L:
Inst Nacl Enfermedades Neoplas, Lima, Peru
Bengio, RG:
Urol Ctr Prof Bengio, Cordoba, Argentina
Scorticati, C:
Clin Hosp Jose San Martin, Buenos Aires, DF, Argentina
Castillejos-Molina, R:
Inst Nacl Ciencias Med & Nutr Salvador Zubiran IN, Mexico City, DF, Mexico
Rodriguez-Covarrubias, F:
Inst Nacl Ciencias Med & Nutr Salvador Zubiran IN, Mexico City, DF, Mexico
Autran-Gomez, AM:
Jimenez Diaz Fdn, Madrid, Spain
Campos-Salcedo, JG:
Mil Hosp, Mexico City, DF, Mexico
Nolazco, A:
British Hosp, Buenos Aires, DF, Argentina
Ameri, C:
German Hosp, Buenos Aires, DF, Argentina
Zampolli, H:
Inst Arnaldo Vieira Carvalho, Sao Paulo, Brazil
Langenhin, R:
Corp Med Paysandu COMEPA, Paysandu, Uruguay
Muguruza, D:
Corp Med Paysandu COMEPA, Paysandu, Uruguay
Machado, MT:
Inst Arnaldo Vieira Carvalho, Sao Paulo, Brazil
ABC Med Sch, Sao Paulo, Brazil
Mingote, P:
Policlin Neuquen, Neuquen, Argentina
Clavijo, J:
Clin Hosp, Montevideo, Uruguay
Nogueira, L:
Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil
Clark, O:
Mil Hosp, Montevideo, Uruguay
Rovegno, AR:
Ctr Educ Med & Invest Clin CEMIC, Buenos Aires, DF, Argentina
Secin, FP:
San Lazaro Fdn, Buenos Aires, DF, Argentina
FUNDES, Buenos Aires, DF, Argentina
Decia, R:
Pasteur Hosp, Montevideo, Uruguay
Guimaraes, GC:
Beneficencia Portuguesa Hosp, Sao Paulo, Brazil
Glina, S:
ABC Med Sch, Sao Paulo, Brazil
Ipiranga Hosp, Sao Paulo, Brazil
Rodriguez-Faba, O:
Puigvert Fdn, Barcelona, Spain
Palou, J:
Puigvert Fdn, Barcelona, Spain
Zequi, SC:
AC Camargo Canc Ctr, Rua Antonio Prudente 211, BR-01509010 Liberdade, SP, Brazil
AC Camargo Canc Ctr, Natl Inst Sci & Technol Oncogen & Therapeut Innov, Sao Paulo, Brazil
Gold, Green Published
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