Preoperative predictors of @entity5 and unfavorable pathology for clinical @entity13712 XXXX treated with @entity1625 : A multi-institutional analysis.

@entity1 @entity1625 @entity5 @entity2357 @entity13712 @entity1358
PURPOSE: To determine preoperative predictors associated with @entity1358 ( @entity1358 ) and unfavorable pathology in small renal masses treated with @entity1625 ( @entity1625 ). MATERIALS AND METHODS: @entity1625 records from 5 centers were retrospectively queried for @entity1 with a clinically localized single @entity5 <4cm on imaging (clinical @entity13712 ). Between 2007 and 2013, 1,009 @entity1 met the inclusion criteria. Unfavorable pathology was defined as any grade III or IV @entity1358 or @entity5 upstaged to pathologic T3a disease. @entity2357 models were used to determine preoperative characteristics associated with @entity1358 and with unfavorable pathology. RESULTS: A total of 771 (76.4%) @entity1 were found to have @entity1358 and 198 (19.6%) had unfavorable pathology. On multivariate, bootstrap-adjusted logistic regression analysis, factors associated with the presence of @entity5 were imaging @entity5 size>= 3cm (odds ratio [OR] = 1.46; P = 0.040), male sex (OR = 1.88; P<0.0001), and nephrometry score>= 8 (OR = 1.64; P = 0.005). These same factors were independently associated with risk of unfavorable pathology: size>= 3cm (OR = 1.46; P = 0.021), male sex (OR = 2.35; P<0.0001), and nephrometry score>= 8 (OR = 1.49; P = 0.015). The c statistic was 0.62 for the predicting @entity5 and 0.63 for unfavorable pathology. CONCLUSIONS: In this multi-institutional cohort, male sex, imaging @entity5 size>= 3cm, and nephrometry score>= 8 were predictors of @entity1358 and adverse pathology following @entity1625 . These factors may assist in risk stratification and selective renal mass biopsy before decision making. Further studies are necessary to validate these findings.
