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Predicting occult multifocality of renal cell carcinoma.

Publication ,  Journal Article
Tsivian, M; Moreira, DM; Caso, JR; Mouraviev, V; Madden, JF; Bratslavsky, G; Robertson, CN; Albala, DM; Polascik, TJ
Published in: Eur Urol
July 2010

BACKGROUND: Multifocal renal cell carcinoma (RCC) has been reported in up to 25% of all radical nephrectomy specimens. Modern imaging tends to underestimate the rate of multifocality. Recognition of multifocality before treatment may guide physicians and patients to the type of intervention and tailor long-term follow-up. OBJECTIVE: Our aim was to develop and assess preoperative nomograms to predict occult multifocal RCC. DESIGN, SETTING, AND PARTICIPANTS: We evaluated 560 consecutive patients undergoing radical nephrectomy for clinically localized suspected sporadic RCC between 2000 and 2008 in a tertiary center. Clinically manifest multifocal lesions were excluded. Logistic regression models were used to assess the potential risk factors of occult multifocality with and without pathologic variables that may be available with preoperative biopsy. Nomograms were developed and assessed for diagnostic properties. INTERVENTIONS: All patients underwent radical nephrectomy. MEASUREMENTS: Assessments of risk factors for occult multifocal RCC were obtained using regression models and nomograms. RESULTS AND LIMITATIONS: The incidence of occult multifocality was 7.9%. Significantly associated predictors of multifocality were male gender, family history of malignancy other than RCC, radiographic size of the lesion, histologic subtype other than clear cell, and Fuhrman grade IV. The two designed nomograms had 0.75 and 0.82 concordance indices, respectively. CONCLUSIONS: Our data suggest that occult multifocal RCC is more frequently associated with small (2-4 cm) renal lesions. Male gender, family history of kidney cancer, histologic subtype, and grade are strongly associated with an increased risk of occult multifocal RCC. The developed nomograms had good predictive accuracy that was enhanced when combined with pathologic variables.

Duke Scholars

Published In

Eur Urol

DOI

EISSN

1873-7560

Publication Date

July 2010

Volume

58

Issue

1

Start / End Page

118 / 126

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Retrospective Studies
  • Nomograms
  • Nephrectomy
  • Middle Aged
  • Male
  • Kidney Neoplasms
  • Incidence
  • Humans
 

Citation

APA
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ICMJE
MLA
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Tsivian, M., Moreira, D. M., Caso, J. R., Mouraviev, V., Madden, J. F., Bratslavsky, G., … Polascik, T. J. (2010). Predicting occult multifocality of renal cell carcinoma. Eur Urol, 58(1), 118–126. https://doi.org/10.1016/j.eururo.2010.03.011
Tsivian, Matvey, Daniel M. Moreira, Jorge R. Caso, Vladimir Mouraviev, John F. Madden, Gennady Bratslavsky, Cary N. Robertson, David M. Albala, and Thomas J. Polascik. “Predicting occult multifocality of renal cell carcinoma.Eur Urol 58, no. 1 (July 2010): 118–26. https://doi.org/10.1016/j.eururo.2010.03.011.
Tsivian M, Moreira DM, Caso JR, Mouraviev V, Madden JF, Bratslavsky G, et al. Predicting occult multifocality of renal cell carcinoma. Eur Urol. 2010 Jul;58(1):118–26.
Tsivian, Matvey, et al. “Predicting occult multifocality of renal cell carcinoma.Eur Urol, vol. 58, no. 1, July 2010, pp. 118–26. Pubmed, doi:10.1016/j.eururo.2010.03.011.
Tsivian M, Moreira DM, Caso JR, Mouraviev V, Madden JF, Bratslavsky G, Robertson CN, Albala DM, Polascik TJ. Predicting occult multifocality of renal cell carcinoma. Eur Urol. 2010 Jul;58(1):118–126.
Journal cover image

Published In

Eur Urol

DOI

EISSN

1873-7560

Publication Date

July 2010

Volume

58

Issue

1

Start / End Page

118 / 126

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Risk Factors
  • Retrospective Studies
  • Nomograms
  • Nephrectomy
  • Middle Aged
  • Male
  • Kidney Neoplasms
  • Incidence
  • Humans