|Authors||Miller BL, Mankowski Gettle L, Van Roo JR, Ziemlewicz TJ, Best SL, Wells SA, Lubner MG, Hinshaw JL, Lee FT, Nakada SY, Huang W, Abel EJ|
|Publish Date||2017 Oct 10|
To compare oncologic and procedural outcomes for renal oncocytic tumors treated with surgery, thermal ablation or active surveillance.Clinical and pathologic data were collected for consecutive patients with a histological diagnosis of oncocytoma, oncocytic neoplasm or chromophobe renal cell cancers (chRCC) from 2003-2016. Independent pathology and radiology review was performed for this study.Of 171 patients, tumor histology included oncocytoma (n=122), chRCC (n=47) and oncocytic neoplasm not otherwise specified (n=2). At initial diagnosis, 67, 14, and 90 patients were treated with surgery, thermal ablation and active surveillance. In 3/19 (16%) patients who had biopsy and subsequent surgery, diagnosis changed from oncocytoma to chRCC. Median follow up was 39.9 months with no difference among choices of treatment modalities (p=0.33). Of 90 patients who began active surveillance, 32 (36%) switched to active treatments (19 thermal ablation and 13 surgery). Median linear growth rate for patients on active surveillance was 1.2 mm/yr. No patients who were managed with active surveillance developed metastatic RCC (mRCC). mRCC was identified in 3 patients and mRCC was cause of death in 2 patients. Patients who developed metastatic disease presented with symptomatic tumors >4cm and were treated with immediate surgery. For oncocytic masses ≤4 cm (n=126), 5-year cancer-specific survival was 100%.Renal oncocytic neoplasms have favorable oncologic outcomes. Active surveillance is safe and is a preferred management for small (≤4 cm) oncocytic renal tumors in selected patients.