Observing Renal Masses May Suffice
Observation may be an appropriate management strategy for renal masses in older patients and those with comorbidities, according to investigators.
Christian Beisland, MD, of the University of Bergen in Bergen, Norway, and his colleagues based that conclusion on a study of 63 patients with renal masses managed mainly by observation. Subjects had a mean age of 76.6 years, and many had comorbid conditions, such as heart disease and hypertension.
The five-year overall survival (OS) and cancer-specific survival (CSS) rates were 42.8% and 93.3%, respectively, the investigators reported in European Urology (2009;55:1419-1429). Five-year OS and CSS were 49.4% and 100% for patients with tumors 4 cm or less in diameter, respectively, and 34.3% and 83.5% for patients with tumors larger than 4 cm. None of the nine patients who delayed radical treatment experienced later disease progression.
Of 41 tumors that were available for growth-rate analysis, 35 (85.4%) had a growth rate of less than 1 cm per year. A growth rate faster than 1 cm per year was observed in only one of the 27 tumors 4 cm or less in diameter compared with five of 14 tumors (36%) that were larger than 4 cm.
The authors concluded that managing renal masses in older patients and others with comorbidities by observation appears to give acceptable results with regard to OS and CSS after five years.