title: Metachronous renal tumours after surgical management of oncocytoma.
abstract: OBJECTIVE
  • To assess the risk of metachronous renal cell carcinoma (RCC) and benign renal tumours after surgical treatment of primary renal oncocytoma.
  
  
  METHODS
  • Patients treated for primary renal oncocytoma between 1970 and 2007 were identified. Tumours were reviewed by a urological pathologist and patients were followed for subsequent renal tumours.
  
  
  RESULTS
  • Of 424 patients with a median follow up of 7.1 year, 17 (4.0%) patients were diagnosed with a metachronous renal tumour at a median of 3.0 years (range 0.3-16 years). Of the 17 metachronous tumours, eight were oncocytoma, four were RCC and five were not resected or biopsied. • Eleven metachronous tumours occurred after solitary unilateral oncocytoma, five occurred after multifocal unilateral oncocytoma, and one occurred after multifocal bilateral oncocytoma. • Estimated 10-year tumour-free and RCC tumour-free survival was 94.8% and 98.7%, respectively. Patients with primary multifocal oncocytoma were at higher risk of metachronous tumour (hazard ratio 4.0; P = 0.007). Initial oncocytoma size (hazard ratio 1.1; P = 0.11) was not highly associated with risk of tumour recurrence.
  
  
  CONCLUSIONS
  • To our knowledge, we report the largest cohort of oncocytoma after surgical management. Metachronous renal neoplasm in a patient with previous oncocytoma is more likely to be benign compared with patients who present with a renal tumour for the first time. Multifocal primary oncocytoma is associated with metachronous renal tumours. • Overall, the risk of metachronous RCC in a patient with an oncocytoma is similar to that of the general population, which does not support the use of routine cross-sectioning imaging surveillance.
authors.affiliation: Department of Urology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: M Adam
authors.initials: MA
authors.lastname: Childs
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Breau
authors.forename: Eric C
authors.initials: EC
authors.lastname: Umbreit
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.forename: John C
authors.initials: JC
authors.lastname: Cheville
authors.forename: R Houston
authors.initials: RH
authors.lastname: Thompson
authors.forename: Michael L
authors.initials: ML
authors.lastname: Blute
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Leibovich
mesh_terms: D018249:Adenoma, Oxyphilic / Q000601:surgery*; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000209:etiology* / Q000601:surgery; D017115:Catheter Ablation; D003452:Cryosurgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012307:Risk Factors; D024162:Second-Look Surgery; D057832:Watchful Waiting; D055815:Young Adult