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RESEARCH PRODUCT
Treatment of cT1a Renal Tumours in Germany: A Nationwide Survey.
Andreas NeisiusSherif MehralivandFrederik C. RoosJoachim W. ThüroffChristian HampelChristian Thomassubject
AdultMalemedicine.medical_specialtyMultivariate analysismedicine.medical_treatmentBiopsyUrology030232 urology & nephrologyRenal functionNationwide surveyKidneyNephrectomy03 medical and health sciencesImpaired renal function0302 clinical medicineInternal medicineGermanySurveys and QuestionnairesBiopsymedicineHumansAgedKidneymedicine.diagnostic_testbusiness.industryNephronsMiddle AgedNephrectomyKidney NeoplasmsSurgerymedicine.anatomical_structure030220 oncology & carcinogenesisMultivariate AnalysisFemaleNephron sparing surgerybusinessTomography X-Ray Computeddescription
<b><i>Objective:</i></b> To identify clinical parameters influencing German urologists treating cT1a renal tumours, we performed a nationwide survey among members of the German urological associations (DGU and BDU). <b><i>Material and Methods:</i></b> In spring 2012, DGU and BDU members were invited to complete our survey. For 8 cases and 3 index patients, participants were asked about their preferred treatment. Multivariate analyses were used to identify significant parameters leading the responders to favour radical nephrectomy (RN) over nephron sparing surgery (NSS) as well as active surveillance (AS) over invasive treatment. <b><i>Results:</i></b> Three hundred six (7.4%) forms were included in our analysis. In patients with larger tumours (4 vs. 2 cm, OR 3.16), endophytic growth (endophytic vs. exophytic, OR 2.70), hilar tumour location (perihilar vs. polar, OR 14.37), normal renal function (normal vs. decreased, OR 1.92) and elderly patients (elderly vs. young, OR 2.14) RN was preferred. Based on decreased renal function (decreased vs. normal, OR 12.74), elderly (elderly vs. young, OR 14.31) and hilar tumour location (perihilar vs. polar, OR 2.14), 77.2% of respondents recommended AS for selected patients. Treating physician factors had no influence on the treatment preference. <b><i>Conclusions:</i></b> Elderly patients with small tumours and impaired renal function were candidates for AS. Younger patients mainly underwent NSS. However, when the tumours' location was endophytic or hilar, RN was recommended.
year | journal | country | edition | language |
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2015-09-16 | Urologia internationalis |