Clinical Features And Prognosis Of Single-center Small Kidney Cancer Undergoing Partial Nephrectomy

Purpose: Small Renal Mass(SRM)refers to benign or malignant tumors with a maximum diameter of no more than 4 cm,as measured by imaging.The incidence of SRM has been increasing in recent years,but only about 30% of small kidney masses are benign.However,there is still a lack of comprehensive research on SRM.Therefore,the purpose of this study is to analyze the preoperative and postoperative clinical and pathological characteristics,as well as the prognosis,of 124 SRM patients in a single center,in order to provide more accurate treatment options for clinical physicians and improve the prognosis and quality of life of patients.Method: From January 2015 to December 2019,the Department of Urology at Sichuan Cancer Hospital treated 124 patients with SRM and their clinical data was collected for this study.All patients underwent surgical treatment and were followed up for 43 months after surgery(with a follow-up time range of 23 to 84 months).This study analyzed the general clinical data,pathological characteristics,TNM staging,tumor diameter,pre-and post-operative clinical indicators,postoperative distant metastasis and recurrence,postoperative mortality,and evaluated the prognosis of SRM patients.Results: Out of the 124 cases of SRM examined,86 cases(69.4%)were males and38 cases(30.6%)were females,resulting in a male-to-female ratio of 2.3:1.The age at onset ranged from 21 to 84 years,with a mean age of 50.9±12.8 years.The highest incidence of SRM was observed in the age group of 42-61 years.81 patients(65.3%)were found through routine physical examination,while 43 patients(34.7%)presented with symptoms during their visit.The pathological type was mainly renal clear cell carcinoma,accounting for 105 cases(84.7%).Among the 124 SRM patients,99 cases(79.8%)underwent minimally invasive surgery(MIS)and 25 cases(20.2%)underwent open partial nephrectomy(OPN),both of which were nephron-sparing surgery(NSS).There were 6 cases(4.8%)who underwent open surgery after a failed MIS.Using the estimated glomerular filtration rate(eGFR)formula,24 patients had improved renal function after surgery,9 had transient elevation,and 13 had sustained elevation.The overall survival rates after 1 year,3 years,and 5 years of surgery were 100%,99.2%,and98.4%,respectively,while the tumor-specific survival rates were 100%,99.2%,and97.6%.Conclusion: SRM is most commonly diagnosed in individuals around 51 years old,and men are 2.3 times more likely than women to develop SRM.A relatively high proportion of patients are detected without symptoms.The main pathological type of SRM is clear cell renal cell carcinoma.NSS is the main treatment for SRM,which can effectively protect renal function and may even improve it in some patients.The 5-year overall survival rate of patients with SRM undergoing NSS surgery is 98%,and their long-term clinical prognosis is good.