Highlights
- •Despite the rising use of renal mass biopsy, the incidence of benign renal masses resected for oncologic indications has remained stable.
- •Oncocytoma poses the most significant diagnostic challenge in attempting to differentiate RCC from benign masses.
- •Smaller tumor size is predictive of finding benign pathology after extirpative surgery.
Abstract
Introduction
Over the past decade and a half, advances in diagnostic imaging as well as an increased
utilization of active surveillance (AS) and renal mass biopsy (RMB) have led to an
improved ability to identify benign lesions prior to partial nephrectomy (PN). We
seek to examine the incidence of benign pathology at the time of PN in a contemporary
cohort of patients undergoing PN for presumed renal cell carcinoma (RCC).
Patients and Methods
We performed a chart review on a prospectively maintained database on a series of
patients who underwent PN between January 1, 2006 and December 31, 2021 for solid
renal masses concerning for RCC.
Results
One thousand two hundred twenty-nine patients were included in the analysis, with
240 patients (19.2%) identified to have benign disease on final pathology. Of patients
with benign disease, (23%) of patients had angiomyolipoma (AML) and 64% had oncocytoma.
Between 2006 and 2021, there was a significant increase in the incidence of benign
pathology after PN. When examining 3-year rolling averages over this same time period,
the incidence of oncocytoma appeared to increase while the incidence of AML decreased.
Conclusion
Despite improvements in diagnostic tools and increased utilization of active surveillance,
the overall incidence of benign pathology, particularly oncocytoma, did not decrease
over time in this contemporary cohort of patients undergoing PN.
Keywords
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Article info
Publication history
Published online: November 17, 2022
Accepted:
November 11,
2022
Received in revised form:
November 7,
2022
Received:
September 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
