Renal kitle tanısıyla nefrektomi yapılan benign lezyonlar

Year 2014, Volume: 9 Issue: 2, 42 - 45, 01.05.2014

Arif Demirbaş Onur Telli Mehmet Ali Karagöz Mücahit Kabar Muzaffer Eroğlu Haşmet Sarıcı

Abstract

Amaç: Bu çalışmanın amacı, renal kitle tanısı ile radikal veya parsiyel nefrektomi yapılmış ve patoloji sonucu benign olan olguların klinik özelliklerini malign olan olgularla karşılaştırmaktır.Gereç ve Yöntemler: Kliniğimizde Ocak of renal mass with the malignant ones.2001 ile Nisan 2013 tarihleri arasında böbrek tümörü ön tanısı ile cerrahi tedavi yapılmış 406 hasta retrospektif olarak incelendi. Histopatolojik değerlendirmeleri sonucu benign tanısı alan 54 hasta Grup 1 ve malign tanılı 352 hasta grup 2 olarak ayrıldı. Patolojik evrelendirme için 2010 TNM evrelendirme sistemi, histolojik alt tipler için 2004 DSÖ sınıflandırması kullanılmıştır. Tümör boyutu, patolojik spesimenlerden santimetre olarak ölçülen en büyük çap olarak kabul edildi. Tüm hastalar yaş, cinsiyet, tanı anındaki semptomları, multifokalite, tümör çapı ve histolojik alt tip açısından incelenmiştir.Bulgular: Olguların ortalama yaşı benign grupta 58,3+/-5,29 iken malign grupta 63,5+/-8,17 idi. Benign grupta 10 %18 hasta kliniğe belirli şikayetlerle başvurmuşken geri kalan 44 %82 hasta ise rastlantısal olarak saptandı. Malign grupta ise 75 %21 hasta rastlantısal, 277 %79 hasta semptomatik olarak saptandı. Multifokalite Grup 1’de 2 %0,03 hastada, grup 2’de 76 %21 hastada görülmüştür. Tümör çapı grup 1’de ortalama 3.8 cm 0.8-8.7 , grup 2‘de ise 6.4 cm 1.1-14 cm olarak ölçülmüştür. Tanı anında semptomların varlığı, multifokalite ve tümör çapı açısından iki grup arasında istatistiksel anlamlı farklar belirlendi p

Keywords

benign lezyonlar , nefrektomi , renal kitle

Benign lesions with diagnosis of renal mass that nephrectomy was performed

Abstract

Objective: The aim of this study is to compare the clinical features of the patients with a benign pathologic report who underwent radical or partial nephrectomy with a preliminary diagnosis of renal mass with the malignant ones. Material and Methods: Between January 2001 and April 2013, 406 patients who underwent surgery in our clinic with a preliminary diagnosis of renal tumor were evaluated retrospectively. Two groups of 54 patients with a benign diagnosis Group 1 and 352 patients with a malignant diagnosis Group 2 were formed based on histopathological examination results. For pathological staging 2010 TNM staging system and for histological subtype classification 2004 WHO classification were used. The longest diameter from those measured from pathological specimens were presumed as tumor size. All patients were reviewed according to age, sex, symptoms at diagnosis, multifocality, tumor size and histological subtypes. Results: The mean age of the patients was 58.3±5.29 46-58 in the benign group, whereas 63.5±8.17 42-83 in the malignant group. 10 patients in the benign group 18% were while the remaining 44 82% patients were detected incidentally. In the malignant group, 277 79% patients were applied symptomatically and 75 21% patients were detected incidentally. Multifocality was observed in 2 patients in Group 1 0.03% and in 76 patients in group 2 21% . In group 1 and group 2, the mean tumor diameter were 3.8 cm and 6.4 cm respectively. Statistically significant difference was detected in the presence of symptoms at diagnosis, multifocality and tumor size between two groups p

Keywords

benign lesions , nephrectomy , renal mass

References

• Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC Can- cerBase No. 10 2010, International Agency for Research on Cancer: Lyon,France.
• Jemal A, Siegal R, Ward E et al; Cancer statistics. 2007,CA Cancer J Clin 2007;57; 43-66.
• Jayson M, Sanders H-Increased incidence of serendipito- usly discovered renal cell carcinoma. Urology 1998;51:203- 5.
• Gill IS, Aron M, Gervais DA, Jewett MA. Clinical practice- Small renal mass. Engl J Med 2010;362:624-34
• Ceylan Y, Günlüsoy B. İzmir Eğitim ve Araştırma Hastane- si-İzmir. Küçük böbrek tümörlerinde izlem. Üroonkoloji Bülteni 2012;11:213.
• Levi F, Ferlay J, Galeone C et al. The changing patern of kidney cancer incidence and mortality in Europe. BJU Int 2008;101:949-58.
• R.Houston Thompson, Jordan M Kurta, Matthew Kaag et al. From the Department of Surgery – Urology Servi- ce, Memorial Sloan-Kettering Cancer Center, NewYork, NY-Tumor size is associated with malignant potential in RCC, Published in final edited form as: J Urol 2009; 181: 2033–2036.
• Frank I, Blute ML, Cheville JC et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 2003;170:2217.
• Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal corti- cal tumours: a retrospective cohort study. Lancet Oncol 2006;7:735.
• Abouassaly R, Lane BR, Novick AC. Active surveillance of renal masses in elderly patients. J Urol 2008;180:505.
• Dechet CB, Sebo T, Farrow G et al. Prospective analysis of intraoperative frozen needle biopsy of solid renal masses in adults. J Urol 1999;162:1282.
• Menogue SR, O’Brien BA, Brown AL et al. Percutaneous core biopsy of small renal mass lesions: a diagnostic tool to beter stratify patients for sugical intervention. BJU Int 2013;111: 146-51.
• Schmidbauer J, Remzi M, Memarsadeghi M,Haitel A,Klingler HC,Katzenbeisser d,et al. Diagnostic accuracy of computed tomography-guided percutaneous biopsy of renal masses. Eur Urol 2008; 53:1003.
• Remzi M, Katzenbeisser D, Waldert M et al. Renal tumour size measured radiologically before surgery is an unreliable variable for predicting histopathological features: Benign tumour are not necessaily small. BJU Int 2013;111(4 Pt B)
• Remzi M, Ozsoy M, Klingler HC et al. Are small renal tumours harmless? Analysis of histopathological featu- res according to tumours 4 cm or less in diameter. J Urol 2006;176: 896-9.
• Kurta JM, Thompson RH, Kundu S et al.Contemporary imaging of patients with a renal mass: Does size on CT equal pathologhical size? BJU Int.2008 (Epub ahead of print)
• Frank I, Blute ML, Cheville JC et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 2003;170:2217.
• Lane BR, Gill IS. 5-Year outcomes of laparoscopic partial nephrectomy. J Urol 2007;177:70.
• Pharnik S, Ziegler S, Roos F et al. Small renal tumors; cor- relation of clinical and pathological features with tumor size. J Urol 2007;178:414-417.
• Huri E; Rastlantısal yakalanmış böbrek tümörlerinde yak- laşım farklı olmalı mı? Türkiye verileri- Üroonkoloji Bül- teni 2012;11:217.
• Lightfoot N, Conlon M, Kreiger N, et al. Impact of nonin- vasive imaging on increased incidental detection of renal cell carcinoma. Eur Urol 2000;37:521-527.
• Li Q, Guan H, Zhang Q, et al. Multicentricity and its as- sociated factors in renal cell carcinoma. Chin Med J Engl 2002; 115:1341-4.
• Baltaci S, Orhan D, Soyupek S, et al. Influence of tumor stage, size, grade, vascular involvement, histological 36 cell type and histological pattern on multifocality of renal cell carcinoma. J Urol 2000; 164:36.