Features of surgical treatment of renal cysts depending on the risk of malignancy


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Abstract

Background. According to national and foreign publications, renal cyst is one of the most common urological diseases with a prevalence up to 20-50%. Aim. To determine the results of surgical treatment of patients with renal cysts, depending on the risk of malignancy. Materials and methods. The analysis of124 patients with symptomatic renal cysts who were treated in the Department of Urology of Regional Clinical Ho spital was carried out. All patients underwent a comprehensive clinical and instrumental evaluation, including contrast-enhanced CT scan of the kidneys. To assess the risk of harboring malignant tumor, the classification of renal cysts of Bosniak (2019) was used. Results. The average age of patients was 56.6+12 years. According to CT, Bosniak I, II, IIF and III cysts were diagnosed in 96 (77.4%), 11 (8.9%), 11 (8.9%) and 6 (4.8%) patients, respectively. The morphologic study revealed renal cell cancer in 8 patients (6.4%), four of whom had Bosniak III cysts and other four had Bosniak IIF cysts. Discussion. The prediction of the harboring of malignancy is a fundamental criterion for selection of patients with renal cysts for surgical treatment. Conclusion. Surgical treatment of symptomatic renal cysts is a justified treatment method, and in patients with Bosniak class II or higher cysts, it is necessary to exclude the malignant lesion. Based on our data, category IIF and III cysts have a high risk of harboring malignant cells, which is 36.4% and 66.7%, respectively. In our opinion, laparoscopic partial nephrectomy is the most rational treatment method in these categories.

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About the authors

P. A Simonov

GBUZ «Regional Clinical Hospital»

Email: wildsnejok@mail.ru
urologist Krasnoyarsk, Russia

M. A Firsov

FGBOU VO Krasnoyarsk State Medical University. Prof. V.F. Voino-Yasenetsky Ministry of Health of Russia

Email: firsma@mail.ru
Ph.D., Head of the Department of Urology, Andrology and Sexology Krasnoyarsk, Russia

D. I Laletin

FGBOU VO Krasnoyarsk State Medical University. Prof. V.F. Voino-Yasenetsky Ministry of Health of Russia

Email: sloth-doc@yandex.ru
assistant of the Department of Urology, Andrology and Sexology Krasnoyarsk, Russia

E. A Alekseeva

FGBOU VO Krasnoyarsk State Medical University. Prof. V.F. Voino-Yasenetsky Ministry of Health of Russia

Email: vohminak@mail.ru
Ph.D., associate professor of the Department of Urology, Andrology and Sexology Krasnoyarsk, Russia

A. I Junker

GBUZ «Regional Clinical Hospital»

Email: junkeralex82@gmail.com
urologist Krasnoyarsk, Russia

References

  1. Bas O., Nalbant I., Sener C., Firat H., Yepl S., Zengin K. et al. Management of Renal Cysts. JSLS. 2015; 19(1):e2014.00097. doi: 10.4293/JSLS.2014.00097
  2. Skolarikos A., Laguna M.P., de la Rosette J.J. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int. 2012;110(2):170-178. doi: 10.1111/j.1464-410X.2011.
  3. Terada N., Ichioka K., Matsuta Y., Okubo K., Yoshimura K., Arai Y. The natural history of simple renal cysts. J. Urol 2002;167(1):21-23.
  4. Kessel HC Jr, Tynes WV 2nd. Spontaneous regression of renal cysts. Urology. 1981;17(4):356-357.
  5. Dalton D., Neman H., Grayhack J.T. The natural history of simple renal cysts: a preliminary study. J. Urol. 1986;135(5):905-908.
  6. Agarwal M.M., Hemal A.K. Surgical management of renal cystic disease. Curr Urol Rep. 2011; 2013:3-10.
  7. Mohsen T., Gomha M.A. Treatment of symptomatic simple renal cysts by percutaneous aspiration and ethanol sclerotherapy. BJU Int. 2005;2013:1369-1372.
  8. Bosniak M.A. The current radiological approach to renal cysts. Radiology. 1986;158:1-10. doi: 10.1148/radiology.158.1.3510019.
  9. Silverman S.G., Pedrosa I., Ellis J.H., Hindman N.M., Schieda N., Smith A.D. et al. Classification of Cystic Renal Masses, Version 2019: An Update Proposal and Needs Assessment. Radiology. 2019;292(2):475-488. doi: 10.1148/radiol.2019182646.
  10. Bosniak M.A. Problems in the radiologic diagnosis of renal parenchymal tumors. Urol. Clin. North. Am. 1993;20:217-230.
  11. Gabr A.H., Gidor Y., Roberts W.W., Wolf J.S. Radiographic surveillance of minimally and moderately complex renal cysts. BJU Int. 2009;103:1116- 1119. doi: 10.1111/j.1464-410X.2008.08171.x.
  12. El-Mokadem I., Budak M., Pillai S., Lang S., Doull R., Goodman C. et al. Progression, interobserver agreement, and malignancy rate in complex renal cysts (> Bosniak category IIF). Urol Oncol. 2014;32(1):24.e21-27. doi: 10.1016/j.urolonc.2012.08.018.
  13. Даренков С.П., Проскоков И.А., Агабекян А.А., Трофимов И.А. Частота малигнизации кист почек категорий 1, 2,2F по классификации BOSNIAK в мультилокулярный кистозный почечно-клеточный рак. Урология. 2018;3;111-115) doi: 10.18565/urology.2018.3.111-115.
  14. Smith A.D., Allen B.C., Sanyal R., Carson J.D., Zhang H., Williams J.H. et al. Outcomes and complications related to the management of Bosniak cystic renal lesions. Am. J. Roentgenol. 2015;204(5):W550-556. doi: 10.2214/AJR.14.13149.
  15. Schoots I.G., Zaccai K., Hunink M.G., Verhagen P.C.M.S. Classification for complex renal cysts reevaluated: a systematic review J. Urol. 2017;198(1):12- 21. doi: 10.1016/j.juro.2016.09.160.
  16. Whelan T.F. Guidelines on the management of renal cyst disease. Can Urol Assoc J. 2010;4:98-99.
  17. Smith A.D., Remer E.M., Cox K.L., Lieber M.L., Allen B.C., Shah S.N., Herts B.R. Bosniak category IIF and III cystic renal lesions: outcomes and associations. Radiology. 2012;262:152-160. doi: 10.1148/radiol.11110888.

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