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• W2759663653 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2018Natural History of Complex Renal Cysts: Clinical Evidence Supporting Active Surveillance Thenappan Chandrasekar, Ardalan E. Ahmad, Kamel Fadaak, Kartik Jhaveri, Jaimin R. Bhatt, Michael A.S. Jewett, and Antonio Finelli Thenappan ChandrasekarThenappan Chandrasekar Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author , Ardalan E. AhmadArdalan E. Ahmad Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author , Kamel FadaakKamel Fadaak Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author , Kartik JhaveriKartik Jhaveri Joint Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author , Jaimin R. BhattJaimin R. Bhatt Department of Urology, University Hospital Ayr, Ayr, United Kingdom More articles by this author , Michael A.S. JewettMichael A.S. Jewett Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author , and Antonio FinelliAntonio Finelli Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.09.078AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated intervention rates, progression and cancer specific survival outcomes in patients with complex renal cysts in a single center experience. Materials and Methods: We used the Montage™ radiology data mining system to retrospectively identify all reported cases of complex renal cyst at our institution from 2001 to 2013. The primary study end points were overall and cancer specific survival. The secondary end points included radiographic progression and upgrading, clinical progression and final histology on surgical pathology. Results: We identified 336 patients with a complex renal cyst, of whom 185 (55.1%), 122 (36.3%) and 29 (8.6%) had Bosniak IIF, III and IV cysts, respectively. Median followup was 67.1 months (range 34.4 to 101.6). In the 332 patients with followup there was 1 cancer specific death (0.3%) and overall mortality was 6.2%. Ten (5.4%), 37 (30.3%) and 18 patients (62.1%) with Bosniak IIF, III and IV, respectively, underwent surgical or ablative intervention. The indication for intervention was predominantly age (intervention vs no intervention mean ± SD age 50.1 ± 15.9 vs 62.5 ± 13.9 years) and complexity. Surgery with radical and partial nephrectomy (23 patients or 35% and 37 or 57%, respectively) was most common and favorable final pathology was identified. Two treated patients experienced recurrence during followup. When excluding patients with von Hippel-Lindau syndrome, the cancer specific survival rate was 100%. Conclusions: Cancer survival and overall survival in patients with Bosniak IIF to IV renal cysts was high with only 1 cancer specific death. No cancer deaths were recorded in patients who did not undergo intervention. Reconsidering management guidelines for complex renal cysts is warranted, particularly consideration for initial surveillance of Bosniak III cysts. References 1 : Incidental finding of renal masses at unenhanced CT: prevalence and analysis of features for guiding management. AJR Am J Roentgenol2011; 197: 139. Google Scholar 2 : Evaluation and management of the renal mass. Med Clin North Am2011; 95: 179. Google Scholar 3 : Contemporary incidence and mortality rates of kidney cancer in the United States. Can Urol Assoc J2014; 8: 247. Google Scholar 4 : Cancer statistics, 2016. CA Cancer J Clin2016; 66: 7. 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Link, Google Scholar © 2018 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLee R, Uzzo R, Anaokar J, Thomas A, Wei S, Ristau B, McIntosh A, Lee M, Chen D, Greenberg R, Viterbo R, Smaldone M, Correa A, Schober J, Ginsburg K, Bukavina L, Magee D, Uzzo N, Parkansky P, Ruth K and Kutikov A (2023) Pathological and Clinical Outcomes in a Large Surveillance and Intervention Cohort of Radiographically Cystic Renal MassesJournal of Urology, Couture F, Hadj-Mimoune S, Michael S, Podasca T, Noël-Lamy M and Richard P (2022) Evolution of Bosniak IIF Renal Cysts and Impact of the 2019 Bosniak ClassificationJournal of Urology, Campbell S, Uzzo R, Karam J, Chang S, Clark P and Souter L (2021) Renal Mass and Localized Renal Cancer: Evaluation, Management, and Follow-up: AUA Guideline: Part IIJournal of Urology, VOL. 206, NO. 2, (209-218), Online publication date: 1-Aug-2021.Pruthi D, Liu Q, Kirkpatrick I, Gelfond J and Drachenberg D (2018) Long-Term Surveillance of Complex Cystic Renal Masses and Heterogeneity of Bosniak 3 LesionsJournal of Urology, VOL. 200, NO. 6, (1192-1199), Online publication date: 1-Dec-2018.Pradere B, Peyronnet B, Delporte G, Manach Q, Khene Z, Moulin M, Roumiguié M, Rizk J, Brichart N, Beauval J, Cormier L, Bex A, Rouprêt M, Bruyère F and Bensalah K (2018) Intraoperative Cyst Rupture during Partial Nephrectomy for Cystic Renal Masses—Does it Increase the Risk of Recurrence?Journal of Urology, VOL. 200, NO. 6, (1200-1206), Online publication date: 1-Dec-2018.Kashan M, Ghanaat M, Hötker A, Duzgol C, Sanchez A, DiNatale R, Blum K, Becerra M, Manley B, Casuscelli J, Chiok M, Coleman J, Russo P, Tickoo S, Akin O and Hakimi A (2018) Cystic Renal Cell Carcinoma: A Report on Outcomes of Surgery and Active Surveillance in Patients Retrospectively Identified on Pretreatment ImagingJournal of Urology, VOL. 200, NO. 2, (275-282), Online publication date: 1-Aug-2018.Smith J (2017) This Month in Adult UrologyJournal of Urology, VOL. 199, NO. 3, (583-585), Online publication date: 1-Mar-2018. Volume 199Issue 3March 2018Page: 633-640 Advertisement Copyright & Permissions© 2018 by American Urological Association Education and Research, Inc.Keywordscarcinomacystsmortalityrenal cellkidney neoplasmsvon Hippel-Lindau diseaseMetricsAuthor Information Thenappan Chandrasekar Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Ardalan E. Ahmad Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Kamel Fadaak Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Kartik Jhaveri Joint Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Jaimin R. Bhatt Department of Urology, University Hospital Ayr, Ayr, United Kingdom More articles by this author Michael A.S. Jewett Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Antonio Finelli Division of Urologic Oncology, Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and University of Toronto, Toronto, Ontario, Canada More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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