Cystic renal cell carcinoma: A report on outcomes of surgery and active surveillance in patients retrospectively identified on pretreatment imaging Journal Article

Authors: Kashan, M.; Ghanaat, M.; Hötker, A. M.; Duzgol, C.; Sanchez, A.; DiNatale, R. G.; Blum, K. A.; Becerra, M. F.; Manley, B. J.; Casuscelli, J.; Chiok, M.; Coleman, J. A.; Russo, P.; Tickoo, S. K.; Akin, O.; Hakimi, A. A.
Article Title: Cystic renal cell carcinoma: A report on outcomes of surgery and active surveillance in patients retrospectively identified on pretreatment imaging
Abstract: Purpose: We evaluated the outcomes of surgical intervention and active surveillance in patients diagnosed with cystic renal cell carcinoma at our hypothesized radiological cutoff of greater than 50% cystic. Materials and Methods: We identified all 430 patients with a pathologically confirmed cystic renal mass that fit our criteria from 2000 to 2015. The 292 patients with a lack of computerized tomography, tumors less than 50% cystic on imaging, multifocal tumors and prior renal cell carcinoma were excluded from study. Patients were stratified into benign or malignant subgroups, and radiological, clinicopathological and oncologic features were determined. Univariate and multivariate associations between clinicoradiological parameters in each group were analyzed. We similarly reviewed the records of a separate cohort of patients treated with active surveillance for cystic renal cell carcinoma. Results: Of the 138 identified cases of cystic renal cell carcinoma 102 (73.9%) were renal cell carcinoma and 36 (26.1%) were benign masses. Of the tumors 77.5% were Fuhrman grade 1-2, 83.4% were stage pT2 or less and 65.9% showed clear cell histology. On univariate analysis male gender, a solid component and increasing Bosniak classification were significant for malignancy. In a separate cohort we identified 38 patients on active surveillance. The growth rate was 1.0 mm per year overall and 2.3 mm per year for the solid component. At a median followup of more than 4 years in all cohorts there was no evidence of recurrence or metastasis of cystic renal cell carcinoma. Conclusions: Patients with unifocal cystic renal cell carcinoma evaluated using a standardized radiological threshold of greater than 50% cystic had an excellent prognosis on active surveillance and after surgical resection. © 2018 American Urological Association Education and Research, Inc.
Keywords: nephrectomy; kidney; watchful waiting; carcinoma; renal cell; cysts
Journal Title: Journal of Urology
Volume: 200
Issue: 2
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2018-08-01
Start Page: 275
End Page: 282
Language: English
DOI: 10.1016/j.juro.2018.02.3087
PROVIDER: scopus
PMCID: PMC6050111
PUBMED: 29496470
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Jonathan Coleman
    184 Coleman
  2. Paul Russo
    449 Russo
  3. Satish K Tickoo
    369 Tickoo
  4. Oguz Akin
    177 Akin
  5. Abraham Ari Hakimi
    129 Hakimi
  6. Andreas Markus Hoetker
    21 Hoetker
  7. Brandon John Manley
    21 Manley
  8. Maria Fernanda   Becerra
    15 Becerra
  9. Mahyar   Kashan
    7 Kashan
  10. Mazyar   Ghanaat
    10 Ghanaat
  11. Michael   Chiok
    2 Chiok
  12. Kyle Blum
    4 Blum
  13. Cihan Duzgol
    1 Duzgol