4cm 이하 신종물의 병리학적 특성: 양성 종양의 빈도
Pathologic Features of Renal Masses, 4cm or Less in Diameter: The Prevalence of Benign Tumors
추설호, 최한용, 이현무, 정진우, 전성수, 김지영, 곽경원, 서성일,
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추설호 ( Choo Seol-Ho )
성균관대학교 의과대학 비뇨기과학교실
최한용 ( Choi Han-Yong )
성균관대학교 의과대학 비뇨기과학교실
이현무 ( Lee Hyun-Moo )
성균관대학교 의과대학 비뇨기과학교실
정진우 ( Chung Jin-Woo )
성균관대학교 의과대학 비뇨기과학교실
전성수 ( Jeon Seong-Soo )
성균관대학교 의과대학 삼성서울병원 비뇨기과학교실
김지영 ( Kim Ji-Young )
성균관대학교 의과대학 삼성서울병원 비뇨기과학교실
곽경원 ( Kwak Kyung-Won )
성균관대학교 의과대학 비뇨기과학교실
서성일 ( Seo Seong-Il )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320080490090781
Abstract
Purpose: We examined the clinical and pathologic findings of small renal masses that were suspected to be malignant. We investigated the prevalence and the predictors of benign tumors.
Materials and Methods: We retrospectively reviewed the medical records of the patients who underwent surgeries for renal lesions between September 1994 and June 2007. We analyzed the pathologic reports and medical records of 586 patients who had a renal mass that was 4cm or less. The mean patient age was 53 years(age range: 15-82). There were 418 male patients(71.3%) and 168 females(28.7%). Multiple logistic regression analysis was done to determine the clinical factors associated with benign renal masses, including the radiological tumor size, a cystic versus solid appearance, gender, age and the presenting symptoms.
Results: Of the 586 renal masses, 62(10.6%) were benign, 520(88.7%) were renal cell carcinoma and 4(0.7%) were other malignancies. The proportion of benign lesions was significantly higher in the females than that in the males(21.4% vs. 6.2%, respectively, p＜0.001) and the proportion of benign lesions was significantly higher for the smaller masses(0-2cm) than for the 2.1-4cm sized tumors(14.7% vs. 9.1%, respectively, p=0.048). On multivariate analysis, gender and tumor size were significantly associated with malignant histology with the males having an odds ratio(OR) of 4.16 (95% CI 2.41-7.19, p＜0.001) and the tumor size more than 2cm having an OR of 1.93(95% CI 1.08-3.44, p=0.03).
Conclusions: A considerable number(10.6%) of benign lesions 4cm or less in the radiological diameter were operated on based on suspicious preoperative imaging. The results of this study seem to help not only for counseling the patients, but also for deciding on a therapeutic modality preoperatively.
키워드
Kidney neoplasms;Nephrectomy;Pathology
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