A single-institution study evaluated renal function outcomes for 114 patients with oncocytoma who were managed with active surveillance versus partial nephrectomy.
Similar long-term outcomes were observed in both treatment groups, researchers reported.
Patients with oncocytoma—a benign renal mass—are encouraged to consider preservation of renal function when determining a management strategy. Thus, a better understanding of the long-term renal function outcomes for patients undergoing active surveillance compared with partial nephrectomy is needed.
Kevin B. Ginsburg, MD, MS, and colleagues at the Fox Chase Cancer Center reviewed their institutional database for patients with biopsy and surgically confirmed oncocytoma from 2000 to 2020. Among the 114 eligible patients, 32 were managed with active surveillance.
The median follow-up was 21 months for partial nephrectomy patients and 44 months for active surveillance patients. Active surveillance patients had an older median age (72 years vs 65 years, P<.001) and lower median baseline renal function (estimated glomerular filtration rate [eGFR], 71 mL/min/1.73m2 vs 82 mL/min/1.73m2; P<.001) compared with partial nephrectomy patients. Researchers also noted that renal mass size from baseline imaging was similar between active surveillance and partial nephrectomy patients (2.9 cm vs 2.8 cm, respectively; P=.634).
Researchers designed a model to predict mean eGFR for patients managed with active surveillance and partial nephrectomy, as well as the probability of progression to chronic kidney disease (CKD) stage III or greater.
Results of the analysis showed that for patients undergoing partial nephrectomy versus active surveillance, there was not a significant difference in predicted longitudinal eGFR (–0.079; 95% CI, –0.18 to 0.023; P=.129) or predicted probability of progression to CKD stage III or greater (odds ratio, 0.61; 95% CI, 0.16-2.33; P=.47).
“Active surveillance should be encouraged for patients with oncocytoma and considered equivalent to partial nephrectomy in terms of renal function preservation,” study authors concluded. “Given similar renal function outcomes in patients undergoing active surveillance and partial nephrectomy, surgery should remain reserved for select patients with oncocytoma.”