Clinical Management of Synchronous and Metachronous Renal Lesions in Patients With Oncocytoma Treated With Nephrectomy: A 30-Year Single-Center Experience

IF 2.4 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2026-02-01 Epub Date: 2025-11-07 DOI:10.1016/j.clgc.2025.102463

Lennert Eismann , Stephen W. Reese , Mark T. Dawidek , Lina Posada Calderon , Andreas Aulitzky , Katiana Vazquez-Rivera , Jonathan A. Coleman , Christian G. Stief , Ed Reznik , Paul Russo , Abraham Ari Hakimi

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引用次数: 0

Abstract

Background

The natural history of renal oncocytoma (RO) following surgical resection remains unclear. We examined a cohort of post-nephrectomy patients with RO, focusing on the management of synchronous and metachronous tumors and their clinical course under surveillance.

Methods

This retrospective, single-institution study analyzed patients from 1990 to 2020 with at least 24 months of follow-up. Patient characteristics and management of synchronous and metachronous tumors were recorded. Cox regression identified risk factors for metachronous tumors, while Kaplan–Meier and log-rank tests assessed metachronous-free survival (MFS).

Results

Among 328 patients (median follow-up: 109 months), 19% (n = 63) had synchronous renal tumors on preoperative imaging. Of these, 27 underwent additional procedures, revealing renal cell carcinoma (RCC)/cortical neoplasm (n = 7), benign lesions (n = 5), or secondary RO (n = 13). Two specimens were unavailable. Metachronous renal lesions developed in 8.5% (n = 28), with 18 undergoing active surveillance. Among 8 patients undergoing biopsy or surgery, 3 had RCC/cortical neoplasm, 4 had RO, and 1 specimen was inconclusive. 5-year MFS were 98.8% in patients with a single lesion at diagnosis and 88% for patients with presence of synchronous renal lesions (P = .004). Higher BMI (HR 1.09, CI 1.01-1.17, P = .026) and synchronous lesions at diagnosis (HR 2.67, CI 1.16-6.14, P = .021) were significant risk factors for metachronous tumors.

Conclusion

Patients with RO have a very low risk of harboring RCC in synchronous or metachronous lesions, supporting active surveillance as a safe strategy. However, those with synchronous kidney tumors at diagnosis face an increased risk of metachronous disease and may require closer monitoring.

查看原文本刊更多论文

肿瘤细胞瘤行肾切除术患者同步和异时性肾脏病变的临床处理：30年单中心经验。

背景：肾嗜瘤细胞瘤（RO）手术切除后的自然病史尚不清楚。我们研究了一组肾切除术后RO患者，重点关注同步和异时性肿瘤的治疗及其临床病程。方法：这项回顾性的单机构研究分析了1990年至2020年的患者，随访至少24个月。记录同步和异时性肿瘤的患者特征和处理方法。Cox回归确定了异时性肿瘤的危险因素，Kaplan-Meier和log-rank检验评估了无异时性生存（MFS）。结果：328例患者（中位随访时间：109个月）中，19% （n = 63）患者术前影像学显示同步肾肿瘤。其中，27人接受了额外的手术，发现肾细胞癌(RCC)/皮质肿瘤（n = 7），良性病变（n = 5）或继发性RO （n = 13）。两个标本无法获得。异时性肾脏病变发生率为8.5% (n = 28)，其中18例接受了主动监测。在8例接受活检或手术的患者中，3例为RCC/皮质肿瘤，4例为RO， 1例标本不确定。诊断时单一病变患者的5年MFS为98.8%，同时存在肾脏病变患者的5年MFS为88% （P = 0.004）。高BMI （HR 1.09, CI 1.01-1.17, P = 0.026）和诊断时病变同步（HR 2.67, CI 1.16-6.14, P = 0.021）是异时性肿瘤的重要危险因素。结论：RO患者在同步或异时性病变中携带RCC的风险非常低，支持主动监测作为一种安全策略。然而，那些在诊断时患有同步肾肿瘤的人面临着异时性疾病的风险增加，可能需要更密切的监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.