Take Home Messages
- •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
Purpose
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 1st 2006 and December 31st 2021 for solid renal masses concerning for RCC.
Results
1229 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.
Conclusions
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.
Microabstract: The authors reviewed data on patients at a single institution, ultimately
analyzing 1229 patients who underwent extirpative surgery for presumed RCC. They found
that 236 (19.2%) patients had benign disease on final pathology. Despite advances
in diagnostic technologies, the rate of benign pathology after presumed oncologic
renal surgery remains high.
MeSH Keywords
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Article Info
Publication History
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.
