Tumour location as a predictor of benign disease in the management of renal masses
Bibliographic record
Abstract
Objective: To investigate the association between tumour locationand the proportion of benign disease in renal masses presumed tobe renal cell carcinoma (RCC) preoperatively.Methods: This Institutional Review Board approved study includes196 patients who underwent surgical treatment for renal masses<5 cm at our institution by a single surgeon between January 2002and June 2009. Based on preoperative imaging, each mass wasdesignated as central (touching or encroaching upon the renal collectingsystem and/or renal sinus) or peripheral. The associationbetween tumour location and benign pathology was determinedusing univariate and multiple logistic regression, including tumoursize and patient sex in the model.Results: The proportion of histologically confirmed benign diseasein this series was 11.2%. The proportion of benign disease bylocation was 5.9% and 19.5% for central and peripheral masses,respectively. The effect of location was found to have a significantprognostic value (p = 0.0273) with an adjusted odds ratio of3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis inperipheral compared to central tumours. Tumour size and patientsex were not significant predictors of benign pathology (p = 0.483and 0.191, respectively).Conclusions: Peripherally located renal masses are more likely tobe benign than centrally located renal masses. This informationmay be used when selecting strategies for the management of renalmasses presumed to be RCC.Objectif : Étudier le lien entre l’emplacement de la tumeur etle taux de maladie bénigne en présence de masse rénales qu’onsuppose être un hypernéphrome avant l’intervention chirurgicale.Méthodologie : L’étude approuvée par le Conseil d’examen del’établissement comptait 196 patients qui ont subi un traitementchirurgical en raison de masses rénales de < 5 cm; toutes les interventionsont été effectuées par le même chirurgien entre janvier2002 et juin 2009. Selon les images obtenues avant l’opération,chaque masse était considérée comme étant centrale (touchantou envahissant le système collecteur et/ou le sinus rénal) ou périphérique.Le lien entre l’emplacement de la tumeur et le caractèrebénin a été déterminé à l’aide de régressions logistiques univariéeset multivariées, dont la taille de la tumeur et le sexe du patient.Résultats : La proportion de tumeurs bénignes confirmées par examenhistologique dans cette série était de 11,2 %. Le taux detumeurs bénignes en fonction de l’emplacement était de 5,9 % etde 19,5 % pour les masses centrales et périphériques, respectivement.L’emplacement s’est révélé avoir une valeur pronostiquesignificative (p = 0,0273), avec un rapport de cotes ajusté de 3,51(IC à 95 % = 1,38 à 19,62) pour la probabilité d’un diagnostic detumeur bénigne en périphérie en comparaison avec un emplacementcentral. La taille de la tumeur et le sexe du patient n’étaientpas des facteurs de prédiction significatifs d’une pathologie bénigne(p = 0,483 et 0,191, respectivement).Conclusions : Les masses rénales en périphérie sont plus susceptiblesd’être bénignes que les masses rénales centrales. Ces donnéespeuvent être utiles au moment de choisir la stratégie de priseen charge des masses rénales supposées être un hypernéphrome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".