Incidental vs symptomatic XXXX : Survival outcomes.

@entity1 @entity1358 @entity5 @entity703
PURPOSE: Currently there is an increase in the incidental diagnosis of @entity1358 ( @entity1358 ). Our aim was to assess the survival of @entity1 with incidental and symptomatic @entity703 who had undergone nephrectomy. @entity1 AND METHODS: We retrospectively assessed 604 @entity1 who underwent renal surgery for @entity1358 between 1983 and 2005. @entity1 were divided in two groups; group 1 had incidental and group 2 had symptomatic @entity5 . The median follow-up was 4 and 3.3  years for groups 1 and 2, respectively. All @entity1 had surgery in the form of radical or partial nephrectomy. Sex, age, @entity5 size, type of surgery, pathological characteristics and @entity1 survival in both groups were evaluated. The statistical analysis included the log-rank, Kaplan-Meier and Cox regression tests. RESULTS: There were 85 @entity1 (14%) in group 1 (mean age 49.6  years) and 519 (86%) in group 2 (mean age 50  years). The mean (SEM, range) @entity5 size was 7.4 (0.4, 1.5-20)  cm in group 1 and 9.7 (0.2, 2-38)  cm in group 2 (P  <  0.001). The most common stage was T1 (52%) and T2 (44%) in groups 1 and 2, respectively, with a predominance of G2 grade and the conventional type histology in both the groups. There was a significant difference in cancer-specific survival (CSS) between the groups (log-rank, P  =  0.017). The 5- and 10-year CSS was 94% and 94% for group 1, and 82.5% and 79.5% for group 2. Cox regression analysis showed that in group 1, only the @entity5 mid-zonal location (P  =  0.093), @entity5 stage pT (P  <  0.001), grade 1 (P  =  0.03), grade 2 (P  =  0.01), grade 4 (P  =  0.01) and the papillary histological type (P  =  0.019) had significant effects on CSS. In group 2, only @entity5 size (P  =  0.022) and stage pN (P  =  0.003) had significant effects on CSS. The @entity5 recurrence rate was 18% and 29% for groups 1 and 2, respectively. CONCLUSIONS: This large study supports the findings of other smaller studies published previously, confirming that at presentation @entity703 are smaller and their diagnosis provides a better prognosis and longer CSS.
