Abstract
Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12%) were benign and 2,364 (88%) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95% CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The incidence of benign tumors decreased from 38% for tumors less than 1 cm to 7% for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25% (OR 1.25, 95% CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0% for tumors less than 1 cm to 59% for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2033-2036 |
| Number of pages | 4 |
| Journal | Journal of Urology |
| Volume | 181 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2009 |
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Keywords
- carcinoma
- histology
- kidney
- neoplasm staging
- renal cell
- risk
ASJC Scopus subject areas
- Urology
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Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases. / Thompson, R. Houston; Kurta, Jordan M.; Kaag, Matthew; Tickoo, Satish K.; Kundu, Shilajit; Katz, Darren; Nogueira, Lucas; Reuter, Victor E.; Russo, Paul.
In: Journal of Urology, Vol. 181, No. 5, 01.05.2009, p. 2033-2036.Research output: Contribution to journal › Article
TY - JOUR
T1 - Tumor Size is Associated With Malignant Potential in Renal Cell Carcinoma Cases
AU - Thompson, R. Houston
AU - Kurta, Jordan M.
AU - Kaag, Matthew
AU - Tickoo, Satish K.
AU - Kundu, Shilajit
AU - Katz, Darren
AU - Nogueira, Lucas
AU - Reuter, Victor E.
AU - Russo, Paul
PY - 2009/5/1
Y1 - 2009/5/1
N2 - Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12%) were benign and 2,364 (88%) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95% CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The incidence of benign tumors decreased from 38% for tumors less than 1 cm to 7% for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25% (OR 1.25, 95% CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0% for tumors less than 1 cm to 59% for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.
AB - Purpose: We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade. Materials and Methods: We identified 2,675 patients treated surgically at our institution for renal cell carcinoma or a benign tumor between 1989 and 2007. Histological subtype and tumor size were obtained from our kidney cancer database and logistic regression analysis was performed. Results: Of the 2,675 tumors 311 (12%) were benign and 2,364 (88%) were renal cell carcinoma. The OR for the association of malignancy with tumor size was 1.16 (95% CI 1.11-1.22, p <0.001), indicating that each 1 cm increase in tumor size was associated with a 16% increase in the odds of malignancy. The incidence of benign tumors decreased from 38% for tumors less than 1 cm to 7% for tumors 7 cm or greater. In patients with clear cell renal cell carcinoma each 1 cm increase in tumor size increased the odds of high grade disease (Fuhrman grade 3-4) compared with low grade disease (Fuhrman grade 1-2) by 25% (OR 1.25, 95% CI 1.21-1.30, p <0.001). In this subset the incidence of high grade lesions increased from 0% for tumors less than 1 cm to 59% for tumors greater than 7 cm. Conclusions: Our results confirm previous observations suggesting that the risks of malignancy and high grade tumors increase with tumor size. Patients with small renal masses are at low risk for harboring a high grade clear cell malignancy, which may be useful during initial consultation.
KW - carcinoma
KW - histology
KW - kidney
KW - neoplasm staging
KW - renal cell
KW - risk
UR - http://www.scopus.com/inward/record.url?scp=64049091856&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64049091856&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2009.01.027
DO - 10.1016/j.juro.2009.01.027
M3 - Article
VL - 181
SP - 2033
EP - 2036
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 5
ER -