Observation versus Resection for Small Asymptomatic XXXX : A Matched Case-Control Study.

@entity1 @entity788 @entity5 @entity3 @entity204
OBJECTIVE: To analyze the natural history of small asymptomatic @entity788 ( @entity788 ) and to present a matched comparison between groups who underwent either initial observation or resection. Management approach for small @entity788 is uncertain. METHODS: Incidentally discovered, sporadic, small (<3  cm), stage I-II @entity788 were analyzed retrospectively between 1993 and 2013. Diagnosis was determined either by pathology or imaging characteristics. Intention-to-treat analysis was applied. RESULTS: A total of 464 @entity1 were reviewed. Observation was recommended for 104 @entity1 (observation group), and these @entity1 were matched to 77 @entity1 in the resection group based on @entity5 size at initial imaging. The observation group was significantly older (median 63 vs. 59  years, p  =  0.04) and tended towards shorter follow-up (44 vs. 57  months, p  =  0.06). Within the observation group, 26 of the 104 @entity1 (25  %) underwent subsequent @entity5 resection after a median observation interval of 30  months (range 7-135). At the time of last follow-up of the observation group, the median @entity5 size had not changed (1.2  cm, p  =  0.7), and no @entity1 had developed evidence of @entity3 . Within the resection group, low-grade (G1) pathology was recorded in 72 (95  %) @entity5 and 5 (6  %) developed a recurrence, which occurred after a median of 5.1 (range 2.9-8.1) years. No @entity1 in either group died from disease. @entity204 from other causes occurred in 11 of 181 (6  %) @entity1 . CONCLUSIONS: In this study, no @entity1 who was initially observed developed @entity3 or died from disease after a median follow-up of 44  months. Observation for stable, small, incidentally discovered @entity788 is reasonable in selected @entity1 .
