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The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years

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The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years. / Filipas, Dejan K; Beatrici, Edoardo; Nolazco, Jose I; Qian, Zhiyu; Marks, Phillip; Labban, Muhieddine; Stone, Benjamin V; Pierorazio, Phillip M; Lipsitz, Stuart R; Trinh, Quoc-Dien; Chang, Steven L; Cole, Alexander P.

In: JNCI CANCER SPECT, Vol. 7, No. 6, pkad084, 31.10.2023.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Filipas, DK, Beatrici, E, Nolazco, JI, Qian, Z, Marks, P, Labban, M, Stone, BV, Pierorazio, PM, Lipsitz, SR, Trinh, Q-D, Chang, SL & Cole, AP 2023, 'The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years', JNCI CANCER SPECT, vol. 7, no. 6, pkad084. https://doi.org/10.1093/jncics/pkad084

APA

Filipas, D. K., Beatrici, E., Nolazco, J. I., Qian, Z., Marks, P., Labban, M., Stone, B. V., Pierorazio, P. M., Lipsitz, S. R., Trinh, Q-D., Chang, S. L., & Cole, A. P. (2023). The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years. JNCI CANCER SPECT, 7(6), [pkad084]. https://doi.org/10.1093/jncics/pkad084

Vancouver

Filipas DK, Beatrici E, Nolazco JI, Qian Z, Marks P, Labban M et al. The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years. JNCI CANCER SPECT. 2023 Oct 31;7(6). pkad084. https://doi.org/10.1093/jncics/pkad084

Bibtex

@article{6b2d79e4ec8e4056a36285bcb10f0cff,
title = "The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years",
abstract = "BACKGROUND: Management of small renal masses often involves a nonoperative approach, but there is a paucity of information about the use and associated predictors of such approaches. This study aimed to determine the trends in and predictors of use of nonoperative management of small renal masses.METHODS: Using data from the National Cancer Database for localized small renal masses (N0/M0, cT1a) diagnosed between 2010 and 2020, we conducted a cross-sectional study. Nonoperative management was defined as expectant management (active surveillance or watchful waiting) or focal ablation. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression models.RESULTS: Of the 156 734 patients included, 10.5% underwent expectant management, and 13.9% underwent focal ablation. Later year of diagnosis was associated with a higher likelihood of nonoperative management. In 2020, the odds of receiving expectant management and focal ablation were 90% (AOR = 1.90, 95% confidence interval [CI] = 1.71 to 2.11) and 44% (AOR = 1.44, 95% CI = 1.31 to 1.57) higher, respectively, than in 2010. Black patients had increased odds of expectant management (AOR = 1.47, 95% CI = 1.39 to 1.55) but decreased odds of focal ablation (AOR = 0.93, 95% CI = 0.88 to 0.99).CONCLUSION: Over the decade, the use nonoperative management of small renal masses increased, with expectant management more frequently used than focal ablation among Black patients. Possible explanations include race-based differences in physicians' risk assessments and resource allocation. Adjusting for Black race in calculations for glomerular filtration rate could influence the differential uptake of these techniques through deflated glomerular filtration rate calculations. These findings highlight the need for research and policies to ensure equitable use of less invasive treatments in small renal masses.",
author = "Filipas, {Dejan K} and Edoardo Beatrici and Nolazco, {Jose I} and Zhiyu Qian and Phillip Marks and Muhieddine Labban and Stone, {Benjamin V} and Pierorazio, {Phillip M} and Lipsitz, {Stuart R} and Quoc-Dien Trinh and Chang, {Steven L} and Cole, {Alexander P}",
note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press.",
year = "2023",
month = oct,
day = "31",
doi = "10.1093/jncics/pkad084",
language = "English",
volume = "7",
journal = "JNCI CANCER SPECT",
issn = "2515-5091",
publisher = "Oxford University Press",
number = "6",

}

RIS

TY - JOUR

T1 - The National Utilization of Non-Operative Management for Small Renal Masses Over 10 Years

AU - Filipas, Dejan K

AU - Beatrici, Edoardo

AU - Nolazco, Jose I

AU - Qian, Zhiyu

AU - Marks, Phillip

AU - Labban, Muhieddine

AU - Stone, Benjamin V

AU - Pierorazio, Phillip M

AU - Lipsitz, Stuart R

AU - Trinh, Quoc-Dien

AU - Chang, Steven L

AU - Cole, Alexander P

N1 - © The Author(s) 2023. Published by Oxford University Press.

PY - 2023/10/31

Y1 - 2023/10/31

N2 - BACKGROUND: Management of small renal masses often involves a nonoperative approach, but there is a paucity of information about the use and associated predictors of such approaches. This study aimed to determine the trends in and predictors of use of nonoperative management of small renal masses.METHODS: Using data from the National Cancer Database for localized small renal masses (N0/M0, cT1a) diagnosed between 2010 and 2020, we conducted a cross-sectional study. Nonoperative management was defined as expectant management (active surveillance or watchful waiting) or focal ablation. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression models.RESULTS: Of the 156 734 patients included, 10.5% underwent expectant management, and 13.9% underwent focal ablation. Later year of diagnosis was associated with a higher likelihood of nonoperative management. In 2020, the odds of receiving expectant management and focal ablation were 90% (AOR = 1.90, 95% confidence interval [CI] = 1.71 to 2.11) and 44% (AOR = 1.44, 95% CI = 1.31 to 1.57) higher, respectively, than in 2010. Black patients had increased odds of expectant management (AOR = 1.47, 95% CI = 1.39 to 1.55) but decreased odds of focal ablation (AOR = 0.93, 95% CI = 0.88 to 0.99).CONCLUSION: Over the decade, the use nonoperative management of small renal masses increased, with expectant management more frequently used than focal ablation among Black patients. Possible explanations include race-based differences in physicians' risk assessments and resource allocation. Adjusting for Black race in calculations for glomerular filtration rate could influence the differential uptake of these techniques through deflated glomerular filtration rate calculations. These findings highlight the need for research and policies to ensure equitable use of less invasive treatments in small renal masses.

AB - BACKGROUND: Management of small renal masses often involves a nonoperative approach, but there is a paucity of information about the use and associated predictors of such approaches. This study aimed to determine the trends in and predictors of use of nonoperative management of small renal masses.METHODS: Using data from the National Cancer Database for localized small renal masses (N0/M0, cT1a) diagnosed between 2010 and 2020, we conducted a cross-sectional study. Nonoperative management was defined as expectant management (active surveillance or watchful waiting) or focal ablation. Adjusted odds ratios (AORs) were calculated using multivariable logistic regression models.RESULTS: Of the 156 734 patients included, 10.5% underwent expectant management, and 13.9% underwent focal ablation. Later year of diagnosis was associated with a higher likelihood of nonoperative management. In 2020, the odds of receiving expectant management and focal ablation were 90% (AOR = 1.90, 95% confidence interval [CI] = 1.71 to 2.11) and 44% (AOR = 1.44, 95% CI = 1.31 to 1.57) higher, respectively, than in 2010. Black patients had increased odds of expectant management (AOR = 1.47, 95% CI = 1.39 to 1.55) but decreased odds of focal ablation (AOR = 0.93, 95% CI = 0.88 to 0.99).CONCLUSION: Over the decade, the use nonoperative management of small renal masses increased, with expectant management more frequently used than focal ablation among Black patients. Possible explanations include race-based differences in physicians' risk assessments and resource allocation. Adjusting for Black race in calculations for glomerular filtration rate could influence the differential uptake of these techniques through deflated glomerular filtration rate calculations. These findings highlight the need for research and policies to ensure equitable use of less invasive treatments in small renal masses.

U2 - 10.1093/jncics/pkad084

DO - 10.1093/jncics/pkad084

M3 - SCORING: Journal article

C2 - 37802923

VL - 7

JO - JNCI CANCER SPECT

JF - JNCI CANCER SPECT

SN - 2515-5091

IS - 6

M1 - pkad084

ER -