title: Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study.
abstract: OBJECTIVE
  To assess epidemiologic characteristics, clinical and pathologic patterns of presentation, and treatment strategies in a contemporary population with renal masses (RMs).
  
  
  METHODS
  The Clinical Research Office of the Endourological Society collected prospective epidemiologic, clinical, and pathologic data on consecutive patients with RMs who were treated during a 1-year period in 98 centers worldwide. Preoperative assessment and treatment were performed according to local clinical practice guidelines.
  
  
  RESULTS
  From January 2010 to February 2012, 4288 patients (4355 cases, 4815 tumors) were treated for a RM. The mean age of the cohort was 61.5 years, and the ratio male:female 1.8:1. Caucasians represented 75% of the population, and the median body mass index was 27. The cohort exhibited a high rate of comorbidity (65.6%), including a 48.5% rate of hypertension; one-third of patients had a combination of two or more comorbidities. One-third of patients (36%) had risk factors for renal-cell carcinoma (RCC), of which smoking and obesity were the most common. Diagnosis was incidental in 67% of cases, and 22.2% of cases had chronic kidney disease stage ≥III at presentation. Median radiologic size was 44 mm (range 2-300 mm) and 68% were cT1. Radical nephrectomy and nephron-sparing surgery (NSS) including ablation were performed in 52% and 46% of cases, respectively, while 3.6% of cases were actively surveyed. Median pathologic size was 43 mm (range 2-300 mm) and 63% of the RCCs were pT1.
  
  
  CONCLUSIONS
  Current patterns of presentation of RMs are consistent with the decreasing trends in age and clinical or pathologic size and increasing incidental diagnosis. Patients exhibit a considerable basal comorbidity and presence of risk factors for RCC. Half of the cases are treated by a nephron-sparing modality with an increase in the penetration of NSS techniques in the contemporary urologic practice.
authors.affiliation: 1 Department of Urology, AMC University of Amsterdam , Amsterdam, The Netherlands .
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Laguna
authors.forename: Ferran
authors.initials: F
authors.lastname: Algaba
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Cadeddu
authors.forename: Ralph
authors.initials: R
authors.lastname: Clayman
authors.forename: Inderbir
authors.initials: I
authors.lastname: Gill
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gueglio
authors.forename: Markus
authors.initials: M
authors.lastname: Hohenfellner
authors.forename: Adrian
authors.initials: A
authors.lastname: Joyce
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lee
authors.forename: Hein
authors.initials: H
authors.lastname: van Poppel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D033162:Incidental Findings; D038622:Internationality; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods* / Q000706:statistics & numerical data; D009399:Nephrons; D009765:Obesity / Q000453:epidemiology; D059351:Organ Sparing Treatments; D011446:Prospective Studies; D011859:Radiography; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D047368:Tumor Burden; D055815:Young Adult