Active Surveillance of Small Renal Masses: Progression Patterns of Early Stage Kidney Cancer
Active Surveillance of Small Renal Masses: Progression Patterns of Early Stage Kidney Cancer
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DOI：
10.1016/j.eururo.2011.03.030
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发表时间：
2011-07-01
期刊：
影响因子：
23.4
通讯作者：
Finelli, Antonio
中科院分区：
文献类型：
--
作者：
Jewett, Michael A. S.;Mattar, Kamal;Finelli, Antonio
背景资料：大多数早期肾癌是肾细胞癌（RCC），并且大多数通过成像偶然诊断为小肾肿块（SRM）。间接证据表明，大多数小RCC生长缓慢，很少metastase.Objective：为了确定的进展和增长率为新诊断的SRM分层针芯活检病理。设计，设置，和参与者：一项在178例老年人和/或老年人中对209例SRM进行主动监测的多中心前瞻性II期临床试验从2004年到2009年，对体弱患者进行了治疗，直到进展。干预：患者接受了系列成像和针芯活检。测量：我们测量了肿瘤直径的变化率（通过成像测量的生长）和进展到>= 4 cm，肿瘤体积加倍或活检组织学转移。
Background: Most early stage kidney cancers are renal cell carcinomas (RCCs), and most are diagnosed incidentally by imaging as small renal masses (SRMs). Indirect evidence suggests that most small RCCs grow slowly and rarely metastasize.Objective: To determine the progression and growth rates for newly diagnosed SRMs stratified by needle core biopsy pathology.Design, setting, and participants: A multicenter prospective phase 2 clinical trial of active surveillance of 209 SRMs in 178 elderly and/or infirm patients was conducted from 2004 until 2009 with treatment delayed until progression.Intervention: Patients underwent serial imaging and needle core biopsies.Measurements: We measured rates of change in tumor diameter (growth measured by imaging) and progression to >= 4 cm, doubling of tumor volume, or metastasis with histology on biopsy.