Charlson score as a single pertinent criterion to select candidates for active surveillance among patients with small renal masses View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-04

AUTHORS

François Audenet, Marie Audouin, Sarah J. Drouin, Eva Comperat, Pierre Mozer, Emmanuel Chartier-Kastler, Arnaud Méjean, Olivier Cussenot, Shahrokh F. Shariat, Morgan Rouprêt

ABSTRACT

PURPOSE: The aim of the study was to assess the outcome after nephron-sparing surgery (NSS) of patients with small renal masses (SRMs) who would have been eligible for active surveillance (AS). METHODS: Data were collected retrospectively for 758 patients who underwent NSS over a 5-year period. Outcomes were assessed in two groups of patients who were eligible for AS according to different criteria. Group 1 criteria were as follows: age >75 years, renal mass ≤4 cm, significant comorbidities [Charlson Comorbidity Index (CCI) >2]. Group 2 criteria were as follows: any SRM ≤ 4 cm regardless of age, severe comorbidities with a 10-year mortality risk >50 % (CCI > 4). The two groups were not compared statistically because some patients were included in both. RESULTS: Fifty-five patients (7.3 %) were included in Group 1 and 62 (8.2 %) in Group 2. There was a significant proportion of benign tumours in Group 1 (N = 6; 11 %) and Group 2 (N = 6; 10 %). Six (11 %) positive margins were observed in Group 1 and 8 (13 %) in Group 2. The 2- and 5-year recurrence-free survival rates were 100 and 77.4 %, respectively, in Group 1, and 88.5 and 79.6 % in Group 2. The 2- and 5-year overall survival rates were 100 and 74.7 % in Group 1, and 96.7 and 78.1 % in Group 2. CONCLUSIONS: The majority of patients with SRMs who would have been eligible for AS had no recurrence after initial tumour removal. In these patients, a CCI > 4 appeared to be a pertinent criterion to identify those patients less likely to benefit from immediate surgery. More... »

PAGES

513-518

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-013-1131-2

DOI

http://dx.doi.org/10.1007/s00345-013-1131-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1040751795

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23873357


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