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Analysis of predictive factors for the malignancy in Bosniak category IIF renal cysts

Other Titles
 Bosniak category IIF 복합 신낭종에서의 악성을 예측할수 있는 인자들에 대한 연구분석 
Issue Date
2012
Description
Dept. of Medicine/석사
Abstract
Purpose: To evaluate the clinical features associated with malignancy in category IIF renal cysts and to determine the optimal length of follow-up for them.Materials and Methods: Radiological and clinical informations were retrospectively searched for Bosniak IIF lesions in computed tomographic (CT) reports from January 1996 to January 2011. 78 adult patients with unenhanced and contrast material-enhanced CT results and with lesions either surgically resected or with 1 year or more of surveillance were included. Renal cyst progression to category III in follow-up studies was defined as an increase in complexity of cyst. I monitored radiologic changes and progression of renal cysts during the follow-up period, and analyzed the pathologic results of those patients who were treated surgically. Results: 21 patients without radiological progression underwent the operation on their own account and of 57 patients under surveillance, five patients (8.8%) showed evidence of progression to category III, with a median time to progression of 9 months (6-26). There was no significant difference in age, gender, cyst size, change in cyst size, multiple septa, wall thickness, calcification, or hyperdensity between the progressive and non-progressive group. Of five patients with radiologic progression, three patients underwent the operation; two patients (66.7%) showed malignancy, whereas of 21 patients without radiological progression underwent the operation; four patients (19.0%) showed malignancy. All six patients reported as malignancy were pT1 renal cell carcinomas and showed no recurrence during postoperative median follow-up of 20 months (4-35). Of 24 patients who underwent the operation, the malignant group showed a significantly older age than the benign group (p=0.035), but the hyperdensity was the sole significant predictive factor for malignancy (OR 13.000, 95% CI 1.201 to 140.734; p=0.035). Conclusions: It is hard to decide the optimal length of follow-up for Bosniak IIF lesions because of variable time to progression, but those with hyperdensity would need more close surveillance because of high risk of malignancy.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/134397
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2. 학위논문 > 5. Others > 기타 학위논문
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