NEW YORK (Reuters Health), Oct 4 - A study of tumor-bearing kidneys shows that tumors beyond a diameter of 3 cm should definitely not be considered harmless, Austrian researchers report in the September issue of the Journal of Urology.
As lead investigator Dr. Mesut Remzi told Reuters Health, "we have clearly shown that histopathological tumor characteristics implicating potential aggressive behavior, rise dramatically with the clinical tumor size of 3 cm."
Dr. Remzi and colleagues at the Medical University of Vienna reviewed data on 287 kidneys in which tumors of 4 cm or less were detected and removed surgically.
Some 22.6% of tumors were 2 cm or less, 35.9% were 2.1 to 3 cm in diameter and the remaining 41.5% were 3.1 to 4 cm in diameter.
In all, 19.5% of tumors were benign with no correlation to tumor size. However, 4.2% of the smallest tumors, 5% of the mid-size group and 25.5% of those in the largest group showed renal cell carcinoma of Fuhrman grade G3/G4.
Corresponding proportions for advanced stage lesions (pT3a or greater) were 4.2%, 14.9% and 35.7%. In addition, distant metastases were found in only 4 patients (2.4%) with tumors of 3 cm or less but in 10 patients (8.4%) with larger tumors.
The aggressive potential of this group of tumors, Dr. Remzi continued, "has to be taken in consideration for treatment choice, especially for surveillance strategies."
Given the difficulty of reliably measuring tumor diameter with imaging studies, the researchers conclude that the threshold for selecting patients for surveillance should be set well below the 3 cm diameter.
By David Douglas
J Urol 2006;176:896-899.
Last Updated: 2006-10-03 14:34:19 -0400 (Reuters Health)
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