Renal angiomyolipoma: a comparison between a non-intervention and interventional group
BAUS ePoster online library. Clancy N. 06/23/21; 319048; p14-1
Disclosure(s): Honorarium: Baxter Health Care, Olympus
Noah Clancy
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Abstract
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Introduction:
Criteria for intervention for angiomyolipoma (AML) of the kidney is debated. An arbitrary 4cm cut off was established to trigger intervention, however, this has been contested. These tumours grow slowly, and active surveillance can be an appropriate management. We assess the natural history and follow up of AMLs and compare this to an intervention cohort.
Patients and Methods:
Patients with radiologically diagnosed AMLs at our institution were categorised into non-intervention (Group A) and intervention (Group B) cohorts. Patients with AML-related genetic syndromes were excluded.
Group A were identified from a single year (2013) with follow-up recorded until 2020.
Group B comprised of patients who has undergone either AML embolisation or nephrectomy between 2008 and 2020.
Results:
Group A consisted of 168 patients with a median age of 61 years and a strong female predilection. Initial presentation was most commonly abdominal pain (37%).
The mean AML size was 12.5mm and had a derived growth rate of 0.21mm/year. 66 patients underwent active surveillance with an average of 3.09 scans. 102 patients had no formal follow-up.
Group B consisted of 23 patients with similar demographics. The mean AML size was 87.6mm. 18 patients were embolised with 5 patients undergoing surgery.
Conclusions:
Our study confirms the growth rate of AML is low and active surveillance appears safe. The need for intervention is associated with increasing size. There is a lack of consensus on appropriate follow up for these patients. This study questions the need for surveillance of the small AML.
Criteria for intervention for angiomyolipoma (AML) of the kidney is debated. An arbitrary 4cm cut off was established to trigger intervention, however, this has been contested. These tumours grow slowly, and active surveillance can be an appropriate management. We assess the natural history and follow up of AMLs and compare this to an intervention cohort.
Patients and Methods:
Patients with radiologically diagnosed AMLs at our institution were categorised into non-intervention (Group A) and intervention (Group B) cohorts. Patients with AML-related genetic syndromes were excluded.
Group A were identified from a single year (2013) with follow-up recorded until 2020.
Group B comprised of patients who has undergone either AML embolisation or nephrectomy between 2008 and 2020.
Results:
Group A consisted of 168 patients with a median age of 61 years and a strong female predilection. Initial presentation was most commonly abdominal pain (37%).
The mean AML size was 12.5mm and had a derived growth rate of 0.21mm/year. 66 patients underwent active surveillance with an average of 3.09 scans. 102 patients had no formal follow-up.
Group B consisted of 23 patients with similar demographics. The mean AML size was 87.6mm. 18 patients were embolised with 5 patients undergoing surgery.
Conclusions:
Our study confirms the growth rate of AML is low and active surveillance appears safe. The need for intervention is associated with increasing size. There is a lack of consensus on appropriate follow up for these patients. This study questions the need for surveillance of the small AML.
Introduction:
Criteria for intervention for angiomyolipoma (AML) of the kidney is debated. An arbitrary 4cm cut off was established to trigger intervention, however, this has been contested. These tumours grow slowly, and active surveillance can be an appropriate management. We assess the natural history and follow up of AMLs and compare this to an intervention cohort.
Patients and Methods:
Patients with radiologically diagnosed AMLs at our institution were categorised into non-intervention (Group A) and intervention (Group B) cohorts. Patients with AML-related genetic syndromes were excluded.
Group A were identified from a single year (2013) with follow-up recorded until 2020.
Group B comprised of patients who has undergone either AML embolisation or nephrectomy between 2008 and 2020.
Results:
Group A consisted of 168 patients with a median age of 61 years and a strong female predilection. Initial presentation was most commonly abdominal pain (37%).
The mean AML size was 12.5mm and had a derived growth rate of 0.21mm/year. 66 patients underwent active surveillance with an average of 3.09 scans. 102 patients had no formal follow-up.
Group B consisted of 23 patients with similar demographics. The mean AML size was 87.6mm. 18 patients were embolised with 5 patients undergoing surgery.
Conclusions:
Our study confirms the growth rate of AML is low and active surveillance appears safe. The need for intervention is associated with increasing size. There is a lack of consensus on appropriate follow up for these patients. This study questions the need for surveillance of the small AML.
Criteria for intervention for angiomyolipoma (AML) of the kidney is debated. An arbitrary 4cm cut off was established to trigger intervention, however, this has been contested. These tumours grow slowly, and active surveillance can be an appropriate management. We assess the natural history and follow up of AMLs and compare this to an intervention cohort.
Patients and Methods:
Patients with radiologically diagnosed AMLs at our institution were categorised into non-intervention (Group A) and intervention (Group B) cohorts. Patients with AML-related genetic syndromes were excluded.
Group A were identified from a single year (2013) with follow-up recorded until 2020.
Group B comprised of patients who has undergone either AML embolisation or nephrectomy between 2008 and 2020.
Results:
Group A consisted of 168 patients with a median age of 61 years and a strong female predilection. Initial presentation was most commonly abdominal pain (37%).
The mean AML size was 12.5mm and had a derived growth rate of 0.21mm/year. 66 patients underwent active surveillance with an average of 3.09 scans. 102 patients had no formal follow-up.
Group B consisted of 23 patients with similar demographics. The mean AML size was 87.6mm. 18 patients were embolised with 5 patients undergoing surgery.
Conclusions:
Our study confirms the growth rate of AML is low and active surveillance appears safe. The need for intervention is associated with increasing size. There is a lack of consensus on appropriate follow up for these patients. This study questions the need for surveillance of the small AML.
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