Trends in the incidence of benign pathological lesions at partial nephrectomy for presumed renal cell carcinoma in renal masses on preoperative computed tomography imaging: a single institute experience with 290 consecutive patients

Abstract

OBJECTIVE: The aim of this study was to determine trends in the incidence of benign lesions in patients undergoing surgery for suspicious renal masses on preoperative computed tomography scan.

METHODS: The records of 1065 patients who underwent open consecutive partial nephrectomy (PN) or radical nephrectomy (RN) between January 2001 and December 2008 were reviewed. Patients who underwent PN during the periods 2001-2002, 2003-2004, 2005-2006, and 2007-2008 were assigned to groups 1, 2, 3 and 4, respectively. The frequencies of benign and malignant lesions in these groups were assessed according to size and histology subtypes.

RESULTS: The ratio of PN to RN was 12.4%, 18.3%, 24.3% and 37.2% in groups 1, 2, 3 and 4, respectively (P < 0.05). The mean size of resected lesions was 2.6 cm (range 0.8-6.2 cm). Of the 290 cases, histopathology revealed benign findings in 52 (17.9%). Benign pathology was found in three of 18 cases (16.7%) in group 1, seven of 36 cases (19.4%) in group 2, 12 of 63 cases (19.0%) in group 3 and 30 of 173 cases (17.3%) in group 4. There was no significant difference in the frequency of benign histology among groups.

CONCLUSION: PN, as opposed to RN, has shown a rising tendency over time. The frequency of benign pathology findings after PN for suspicious renal masses on preoperative computed tomography imaging has not decreased. Proper management should favor nephron-sparing surgery for renal lesions if such lesions can be removed satisfactorily with PN.