Predictive Factors Of Benign Histology For Renal Masses (Smaller Than 4 Cm) After Partial Nephrectomy

Objective: To investigate predictive factors of benign histology for renal masses(smaller than 4 cm)in Chinese patients after partial nephrectomy on preoperative imaging.Methods and materials: We retrospectively investigated the medical records of 220 patients who underwent partial nephrectomy in the First Affiliated Hospital of Fujian Medical University for renal masses smaller than 4 cm on preoperative imaging between January 2003 and June 2010.All patients had preoperative imaging data(CT/CTA)and had R.E.N.A.L nephrometry score.Demographic and clinicopathologic parameters were compared between benign lesions and malignant lesions.Logistic regression was done to identify parameters associated with benign lesions.Results: In the 220 patients,35 tumors(15.9%)were benign,185tumors(84.1%)were malignant,On univariate analysis,the proportion of benign lesions was significantly higher in female patients and with younger age as a presenting symptom.On multiple logistic regression analysis,age(OR,1.071;95%CI,1.032-1.113;P<0.001),sex(OR,2.735;95%CI,1.311-5.706;P<0.001),CT value(OR,23.772;95%CI,9.468-58.573;P<0.001)were independent predictors of benign histologic features.BMI,Tumor size,tumor location and surgical approach were not significant predictors.The lower R.E.N.A.L nephrometry score,the greater the postoperative renal pathological benign possibilities.(OR,1.923;95%CI,1.012?2.771;P=0.030).Benign lesions is related with exophytic/endophytic properties of the tumor(OR,9.500;95%CI,3.090-29.208;P<0.001),but without obvious correlation with nearness of the tumor to the collecting system or sinus,anterior/posterior and location relative to the polar lines.Conclusion:The findings in this cohort of Chinese patients show benign lesions for renal masses(smaller than 4 cm)after partial nephrectomy is 15.9%.Age,sex,CT value and exophytic/endophytic properties of the tumor were independent predictors of benign histologic features.Female gender,younger age,CT value is negative and exophytic tumor property are independent predictors of benign histological features.The lower R.E.N.A.L nephrometry score,the greater the postoperative renal pathological benign possibilities.