MP28-04 DO HIGH-VOLUME RENAL TUMOR BIOPSY CENTERS HAVE LOWER RATES OF BENIGN HISTOLOGY FOLLOWING NEPHRECTOMY FOR SMALL RENAL MASSES?
Notice bibliographique
Résumé
You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging I1 Apr 2018MP28-04 DO HIGH-VOLUME RENAL TUMOR BIOPSY CENTERS HAVE LOWER RATES OF BENIGN HISTOLOGY FOLLOWING NEPHRECTOMY FOR SMALL RENAL MASSES? Patrick O. Richard, Luke Lavallée, Frederic Pouliot, Lisa Martin, Maria Komisarenko, Jean-Baptiste Latouff, and Antonio Finelli Patrick O. RichardPatrick O. Richard , Luke LavalléeLuke Lavallée , Frederic PouliotFrederic Pouliot , Lisa MartinLisa Martin , Maria KomisarenkoMaria Komisarenko , Jean-Baptiste LatouffJean-Baptiste Latouff , and Antonio FinelliAntonio Finelli View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.904AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The management of small renal masses (SRMs) has been associated with a significant risk of overtreatment. Renal tumor biopsies (RTBs) have been proposed as a diagnostic alternative to identify pre-treatment histology of SRMs. In spite of their potential benefits, many urologists are reluctant to use RTB because of a sentiment that RTBs seldom influence treatment decision. The objective of this study was to evaluate whether the routine use of RTB leads to lower rates of nephrectomy for histologically benign tumors. METHODS This was a retrospective multicenter study which identified all patients who underwent a radical or partial nephrectomy for a lesion suspicious for localised RCC and measuring =4cm (cT1a and pT1a or pT3a) between January 1st, 2013 and December 31st, 2015 in four high-volume Canadian centers. The baseline characteristics of the patients who were managed in routine biopsy (RB) and non-routine biopsy (NRB) centers were compared using the Wilcoxon rank-sum test for continuous variables and the chi-squared for proportions. A logistic regression model was used to test the association between the type of procedural center (RB vs. NRB centers) and the odds of obtaining a histologically benign tumor following nephrectomy. RESULTS 542 nephrectomised SRMs were included in the study. Rates of pre-treatment RTB were 63% and 12% in the RB centers and NRB centers, respectively. The overall rate of histologically benign tumors at the time of surgery was 11%. This rate was considerably less among RB centers than in NRB centers (5% vs. 16%; p<0.001). On multivariable analysis, older patients, smaller tumor size and NRB centers were all significantly associated with greater odds of finding a benign histology following nephrectomy. Compared to NRB centers, RB centers were 4 times less likely to perform surgery that resulted in a benign histologic tumor at final pathology (OR 0.25, 95%CI: 0.1-0.5). CONCLUSIONS The routine use of RTB to identify pre-treatment histology of SRMs is associated with less surgery for benign tumors and the potential for short and long-term morbidity associated with these procedures. The results of this study provide further evidence to support RTB as a triage tool to guide management and decrease overtreatment. Further well-designed prospective trial will be required to validate our findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e357-e358 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Patrick O. Richard More articles by this author Luke Lavallée More articles by this author Frederic Pouliot More articles by this author Lisa Martin More articles by this author Maria Komisarenko More articles by this author Jean-Baptiste Latouff More articles by this author Antonio Finelli More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,182 | 0,036 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».