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Background <p>Small renal masses (SRMs), defined as renal tumors &lt; 4&#xa0;cm, are increasingly detected due to the widespread use of imaging modalities. Data from India regarding the clinical characteristics and outcomes of SRMs remain limited. This multi-institutional study led by the Society of Genitourinary Oncologists aims to delineate the demographic, radiological, and pathological profiles of SRMs in the Indian population and evaluate management outcomes following partial nephrectomy.</p> Methods <p>A retrospective analysis was conducted across multiple tertiary care centers in India from January 2013 to December 2022. Patients aged ≥ 18&#xa0;years with SRMs undergoing partial nephrectomy were included. Data on demographics, clinical presentation, radiology (including RENAL nephrometry score), intraoperative factors, postoperative outcomes, and histopathology were analyzed. Statistical associations between renal scores, BMI, tumor stage, and histologic type were assessed.</p> Results <p>A total of 432 patients were analyzed, with a male predominance (76.6%) and mean age of 51.8 ± 12.9&#xa0;years. Most SRMs (80.3%) were incidentally detected. Robotic-assisted partial nephrectomy was performed in 85% of cases, with a mean operative time of 228.7 ± 91.8&#xa0;min and clamp time of 25.5 ± 9.1&#xa0;min. The overall complication rate was 7%. Clear cell RCC was the most common histology (71.1%), while benign lesions accounted for 11.6%. Positive margins were seen in 1.4% of cases. BMI correlated significantly with renal complexity (p = 0.010). At a median follow-up of 36&#xa0;months, recurrence occurred in 0.9% of patients. Female patients under 45&#xa0;years had a higher incidence of benign pathology (34.1%, p &lt; 0.001).</p> Conclusions <p>This first large-scale Indian collaborative study highlights unique epidemiologic and pathologic trends in SRMs, including lower benign histology rates and higher complexity in obese patients. Robotic partial nephrectomy demonstrated favorable perioperative and oncologic outcomes. The findings support individualized management strategies and emphasize the need for structured follow-up protocols in the Indian setting.</p>

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Clinical profile and management outcomes of small renal masses: a collaborative multi-institutional Indian study led by the society of genitourinary oncologists

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Deerush Kannan Sakthivel,
  • Sanjai Addla,
  • Ginil Kumar Pooleri,
  • SK Raghunath,
  • Ashwin Tamhankar,
  • Gopal Sharma,
  • Gagan Gautam,
  • Amitabh Singh,
  • Rupesh Shah,
  • Sudhir Rawal,
  • Narasimhan Ragavan

摘要

Background

Small renal masses (SRMs), defined as renal tumors < 4 cm, are increasingly detected due to the widespread use of imaging modalities. Data from India regarding the clinical characteristics and outcomes of SRMs remain limited. This multi-institutional study led by the Society of Genitourinary Oncologists aims to delineate the demographic, radiological, and pathological profiles of SRMs in the Indian population and evaluate management outcomes following partial nephrectomy.

Methods

A retrospective analysis was conducted across multiple tertiary care centers in India from January 2013 to December 2022. Patients aged ≥ 18 years with SRMs undergoing partial nephrectomy were included. Data on demographics, clinical presentation, radiology (including RENAL nephrometry score), intraoperative factors, postoperative outcomes, and histopathology were analyzed. Statistical associations between renal scores, BMI, tumor stage, and histologic type were assessed.

Results

A total of 432 patients were analyzed, with a male predominance (76.6%) and mean age of 51.8 ± 12.9 years. Most SRMs (80.3%) were incidentally detected. Robotic-assisted partial nephrectomy was performed in 85% of cases, with a mean operative time of 228.7 ± 91.8 min and clamp time of 25.5 ± 9.1 min. The overall complication rate was 7%. Clear cell RCC was the most common histology (71.1%), while benign lesions accounted for 11.6%. Positive margins were seen in 1.4% of cases. BMI correlated significantly with renal complexity (p = 0.010). At a median follow-up of 36 months, recurrence occurred in 0.9% of patients. Female patients under 45 years had a higher incidence of benign pathology (34.1%, p < 0.001).

Conclusions

This first large-scale Indian collaborative study highlights unique epidemiologic and pathologic trends in SRMs, including lower benign histology rates and higher complexity in obese patients. Robotic partial nephrectomy demonstrated favorable perioperative and oncologic outcomes. The findings support individualized management strategies and emphasize the need for structured follow-up protocols in the Indian setting.