title: The growth rate of "clinically significant" renal cancer.
abstract: Surveillance studies of enhancing renal masses report on a mean tumor growth rate of about 0.3 cm/year. In most of these studies however, only small tumors in elderly patients were followed. In the current report, we attempt to evaluate the growth rate of "clinically significant" renal carcinomas defined as tumors that were treated immediately upon diagnosis. 46 patients (mean age 64 years SD 11 years) were treated for renal carcinoma. All had a cross-sectional imaging studies performed 6-60 months prior to diagnosis of kidney cancer demonstrating no tumor. Tumor growth rate was calculated by dividing tumor's largest diameter by the time interval between the normal kidney imaging and diagnosis of renal cancer. Mean tumor diameter was 4.5 cm (SD 2.4 cm). Mean time period from the normal imaging to diagnosis of renal cancer was 33.6 months (SD 18 months). According to the proposed model, the average growth rate of "clinically significant" renal carcinomas was 2.13 cm/year (SD 1.45, range 0.2-6.5 cm/year). Tumor growth rate correlated inversely with patient's age (p = 0.007). Patient gender or Fuhrman's grade did not correlate however. The growth rate of "clinically significant" renal cancer appears to be higher than the rate reported in surveillance trials. Renal tumors tend to grow faster in young patients. As such, variable growth rate should be taken into account when considering active surveillance in young patients and when designing trials for evaluation of anti-cancer agents.
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Ofer N
authors.initials: ON
authors.lastname: Gofrit
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Yutkin
authors.affiliation: Section of Urology, Department of Surgery, University of Montreal Health Center (CHUM), 235 Rene Levesque Est, Montreal, QC H2X 1N8 Canada.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Zorn
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Mordechai
authors.initials: M
authors.lastname: Duvdevani
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Ezekiel H
authors.initials: EH
authors.lastname: Landau
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Guy
authors.initials: G
authors.lastname: Hidas
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, POBox 12000, 91120 Jerusalem, Israel.
authors.forename: Dov
authors.initials: D
authors.lastname: Pode
keywords: Cross-sectional imaging; Growth rate; Renal carcinoma