Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 233.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMC+Urol 2015 ; 15 (ä): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Treatment of renal angiomyolipoma: pooled analysis of individual patient data #MMPMID26710923
Kuusk T; Biancari F; Lane B; Tobert C; Campbell S; Rimon U; D?Andrea V; Mehik A; Vaarala MH
BMC Urol 2015[]; 15 (ä): ä PMID26710923show ga
Background: This study was performed to evaluate the impact of baseline characteristics and treatment methods on the outcome of sporadic renal angiomyolipoma (AML). Methods: This was a pooled analysis of individual data of 441 patients with AML retrieved from 58 studies and 3 institutional series. Results: Ninety-three patients underwent nephrectomy, 163 partial nephrectomy/enucleation, 128 embolisation, 19 cryoablation, 6 radiofrequency ablation, and 32 conservative treatment. Their mean follow-up period was 44.5 months. Patients who experienced major bleeding at presentation had significantly larger tumours than did those without bleeding (mean diameter, 10.1 vs. 5.9 cm, respectively; p?0.0001). A total of 9.4 % and 26.4 % of bleeding tumours had a diameter of <4 and <6 cm, respectively. A tumour diameter of ?8.0 cm (hazard ratio, 2.07; 95 % confidence interval, 1.20?4.77) and the treatment method (p?=?0.001) were independent predictors of re-intervention. The risk of re-intervention was significantly higher after embolisation, particularly for large tumours (5-year rate of freedom from re-intervention: diameter of ?8.0 cm, 49.2 %; diameter of <8.0 cm, 74.8 %; p?=?0.018). Conservatively treated AMLs had a mean baseline diameter of 3.2?±?2.7 cm; after 41 months, their mean diameter was 3.7?±?3.1 cm (p?=?0.109). Conclusions: The prevalence of major bleeding is high in sporadic AMLs with a diameter of >6 cm. These results suggest that conservative treatment can be considered in AMLs of <6 cm in diameter. Among current treatment methods, embolisation was associated with a significantly higher risk of re-intervention. Further studies are needed to define risk factors for bleeding and assess the relative benefits of different treatment modalities.