Is anatomic complexity associated with renal tumor growth kinetics under XXXX ?

@entity1 @entity5 @entity3457 @entity3
INTRODUCTION: Linear growth rate (LGR) is the most commonly employed trigger for definitive intervention in @entity1 with renal masses managed with an initial period of @entity3457 ( @entity3457 ). Using our institutional cohort, we explored the association between @entity5 anatomic complexity at presentation and LGR in @entity1 managed with @entity3457 . METHODS AND MATERIALS: Enhancing renal masses managed expectantly for at least 6 months were included for analysis. The association between Nephrometry Score and LGR was assessed using generalized estimating equations, adjusting for the age, Charlson score, race, sex, and initial @entity5 size. RESULTS: Overall, 346 @entity1 (401 masses) met the inclusion criteria (18% >=  cT1b), with a median follow-up of 37 months (range: 6-169). Of these, 44% @entity1 showed progression to definitive intervention with a median duration of 27 months (range: 6-130). On comparing @entity1 managed expectantly to those requiring intervention, no difference was seen in median @entity5 size at presentation (2.2 vs. 2.2 cm), whereas significant differences in median age (74 vs. 65 y, P < 0.001), Charlson comorbidity score (3 vs. 2, P<0.001), and average LGR (0.23 vs. 0.49 cm/y, P < 0.001) were observed between groups. Following adjustment, for each 1-point increase in Nephrometry Score sum, the average @entity5 LGR increased by 0.037 cm/y (P = 0.002). Of the entire cohort, 6 @entity1 (1.7%) showed progression to @entity3 . CONCLUSIONS: The demonstrated association between anatomic @entity5 complexity at presentation and renal masses of LGR of clinical stage 1 under @entity3457 may afford a clinically useful cue to tailor individual @entity1 radiographic surveillance schedules and warrants further evaluation.
