Active surveillance (AS) of biopsy-proven renal oncocytomas may reduce overtreatment. However, on biopsy, the risk of misdiagnosis owing principally to entities with peculiar hybrids and overlap morphology, and phenotypes argues for early intervention.
To assess the benefit and harm of AS in biopsy-proven renal oncocytoma.
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We systematically searched PubMed, Scopus, and Web of Science databases from September 26 up to October 2021, for studies that analyzed the outcomes of AS in patients with biopsy-proven renal oncocytoma.
A total of ten studies with 633 patients met our inclusion criteria and were included for analysis. After a median follow-up of 34.5 mo (95% confidence interval [CI] 30.6-38.4), the overall definitive treatment rate from AS to definitive treatment was 17.3% (n = 75/433, six studies). The pooled pathological agreement between the initial renal mass biopsy and the surgical pathology report was 91.1%. The main indications for surgery during follow-up were rapid tumor growth and patient request. The pooled median growth rate was 1.55 mm/yr (95% CI 0.9-2.2). No metastasis or death related to renal oncocytoma was reported.
Annual tumor growth of biopsy-proven renal oncocytoma is low. AS is oncologically safe, with favorable compliance of patients. Crossover to definitive treatment revealed a strong concordance between biopsy and final pathology. Further studies on the long-term outcomes of AS are needed.
In this study, we examined the benefit and harm of active surveillance (AS) in biopsy-proven oncocytoma. Based on the available data, AS appears oncologically safe and may represent a promising alternative to immediate treatment. Patients should be included in AS decision discussions.
European urology open science. 2022 May 19*** epublish ***
Michael Baboudjian, Daniel Moser, Takafumi Yanagisawa, Bastien Gondran-Tellier, Eva M Compérat, Damien Ambrosetti, Laurent Daniel, Cyrille Bastide, Shahrokh F Shariat, Eric Lechevallier, Pietro Diana, Alberto Breda, Benjamin Pradere, Romain Boissier
Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria., Department of Pathology, Medical University of Vienna, Vienna, Austria., Department of Pathology, CHU Nice, University of Côte d'Azur, Nice, France., Department of Pathology, Aix-Marseille University, APHM, La Timone University Hospital, Marseille, France., Department of Urology, Aix-Marseille University, APHM, North University Hospital, Marseille, France., Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.