Debelle, T.E.H. (Tess) (2021) Renal Cell Carcinoma; the Rates of Overtreatment of T1 Renal Masses by Means of Partial Nephrectomy Throughout the Netherlands. thesis, Medicine.
Full text available on request.Abstract
Objective: To determine the rates of surgically resected cT1 benign renal masses removed throughout the Netherlands by means of partial nephrectomy (PN), and thus evaluate overtreatment. Methods: This multicenter retrospective cohort study analyzed the histopathological outcome of 1,511 PN’s performed for T1 tumours between June 1, 2014 and December 31, 2018. Patient and tumour characteristics were used in order to properly evaluate the rate of overtreatment, as well as determine if and which predisposing factors influence the chance of having a benign pathology. Results: Of all the PN’s included, 1,198 (79.3%) were categorized as cT1a, and 313 (20.7%) were categorized as cT1b. The mean patient age was 63.2 years (SD: 11.1 years) at the date of the PN, and the mean size of the renal mass removed was 3.1 cm (SD: 1.2 cm). A total of 177 (11.7%) of the tumours removed were benign, and 1,332 (88.2%) were malignant (p = 0.021). There was a significantly higher rate of benign pathology removed from the cT1a tumours (152/1,198, or 12.7%) than from the cT1b tumours (25/313, or 8.0%). A significant correlation was found between an increase in maximal diameter of the tumour (p = 0.035), as well as an increase in age of the patient (p = 0.001), with the chance of having a malignant pathology. Gender was not a significant predisposing factor (p = 0.079). From the malignant tumours, larger tumour size (p = 0.025) and an increase in age (p = 0.034) were associated with a higher Fuhrman grade. Conclusion: A substantial amount of T1 renal masses removed by means of PN throughout the Netherlands showed a benign pathology. Smaller tumour size, as well as younger age, were associated with a higher chance of a benign pathology. Keywords: Renal cell carcinoma, renal mass, tumour, partial nephrectomy, kidney, neoplasm, renal tumour biopsy, benign, malignant, overtreatment, incidence.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Haan, dr. T. de and Widdershoven, drs. C. and Gietelink, dr. L. and Lagerveld, dr. B. and Zondervan, dr. P. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 08:24 |
| Last Modified: | 06 Jan 2022 08:24 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2955 |
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