Renal Function Preservation of Active Surveillance Versus Partial Nephrectomy in Oncocytoma

Given the possibility of overtreatment of benign tumors, researchers evaluated management strategies for patients with oncocytomas and reported that active surveillance (AS) did not result in inferior renal function outcomes when compared to partial nephrectomy (PN), contrary to a recently published report. The study was presented at the 22nd Annual Scientific Meeting from the Society of Urologic Oncology.

According to the lead author, Alberto A. Castro Bigalli, MD, patients undergoing AS and PN showed similar declines in renal function. “AS for oncocytomas and other benign renal lesions should remain the preferred management strategy,” Dr. Bigalli stated.

Renal function was assessed via patients’ estimated glomerular filtration rate (eGFR). Serum Cr and eGFR were recorded at six-month intervals for up to five years. The researchers used the Wilcoxon rank-sum test to compare change in eGFR from baseline between the two groups. ANCOVA regression was used to estimate the mean change in eGFR.

Thirty-six out of 119 patients in the cohort were managed with AS. Patients on AS had less eGFR decline compared with patients who underwent PN at the last follow-up, but this did not reach statistical significance (4.8 mL/min vs. 10.0, P = 0.13). The predicted mean change in eGFR from baseline to last follow up was -7.78 mL/min for AS patients and -9.4 mL/min for PN patients (P = 0.666).

According to Dr. Bigalli, their findings directly dispute research suggesting that PN may achieve better renal function preservation in patients with oncocytoma. “Recent concerns regarding long-term renal function in patients with unresected oncocytoma should not deter providers from offering AS to avoid overtreatment of benign renal tumors,” he added.