scholarly journals Ultrasound Features for Determining the Risk of Malignancy in Unilocular-Solid Adnexal Masses in Premenopausal Women without Ascites and/or Carcinomatosis

Author(s):  
Juan Luis Alcázar ◽  
Jesús Utrilla-Layna ◽  
Leire Juez ◽  
Almudena Peces ◽  
Txanton Martinez-Astorquiza Corral ◽  
...  

ABSTRACT Purpose To assess what clinical and ultrasound features could be most helpful for discriminating benign from malignant unilocular cysts with solid components in premenopausal women with no signs of ascites or carcinomatosis. Materials and methods Retrospective study comprising 91 women with preoperative diagnosis of unilocular-solid cyst that underwent surgical removal. The following variables were assessed: age, complaints at presentation, bilaterality, mean size of the lesion, number of papillary projections, size of solid component, surface of solid component (smooth or irregular), amount of color within solid component (no flow, minimal flow, moderate flow, abundant flow). Definitive histopathological diagnosis was used as gold standard. Multivariate logistic regression analysis was performed to identify which variables were independent predictors of malignancy and their odds ratios (OR). Results Malignant lesions had significantly larger tumor size, more number of solid components, larger size of solid component, more frequency of irregular surface in the solid component and more frequent moderate or abundant vascularization within the solid component. Logistic regression analysis identified amount of color (OR: 48.7), solid component's surface (OR: 29.1) and mean size of the lesion (OR: 1.58) as independent predictors for malignancy. Conclusion Tumor size, irregular surface and the presence of moderate or abundant color score within the solid component are the features more frequently associated to malignancy in unilocular-solid adnexal cysts in premenopausal women. How to cite this article Juez L, Peces A, Corral TMA, Orozco R, Utrilla-Layna J, Caparros M, Alcazar JL. Ultrasound Features for Determining the Risk of Malignancy in Unilocular- Solid Adnexal Masses in Premenopausal Women without Ascites and/or Carcinomatosis. Donald School J Ultrasound Obstet Gynecol 2015;9(2):112-117.

Author(s):  
Petronella A.J. van den Akker ◽  
Petra L.M. Zusterzeel ◽  
Anette L. Aalders ◽  
Marc P.L.M. Snijders ◽  
Rahul A.K. Samlal ◽  
...  

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 515-515
Author(s):  
Wassim Bazzi ◽  
Sheila Dejbakhsh ◽  
Melanie Bernstein ◽  
Jonathan A. Coleman ◽  
Paul Russo

515 Background: Previous reports describe that 20% of small renal masses (SRM) are benign and women are twice as likely to have benign pathology. In this study we further explore the association of baseline health and gender with SRM pathology. Methods: After IRB approval, retrospective chart review of patients who have undergone nephrectomy at Memorial Sloan-Kettering Cancer Center from 05/1998 to 10/2012 with final path ≤ 4cm and staged as pT1a if malignant. Tumor size ≤ 4cm was chosen to limit the tumor mass effect on renal function. Patients with solitary kidney, multiple and bilateral tumors, and history of prior renal surgeries were excluded. Collected data included age, gender, race, ASA class for medical co−morbidities which were divided into low (I−II) and high (III−IV), procedure, preoperative serum creatinine, eGFR, and final pathology. eGFR was calculated using the CKD−Epi formula. Preoperative Chronic kidney disease (pCKD) was defined as eGFR < 60 mL/min per 1.73 m2. Malignant pathologies were clear cell renal cell carcinoma (RCC), papillary RCC and chromophobe RCC whereas benign were oncocytoma, angiomyolipoma and other. Logistic regression analysis was performed to determine clinical factors associated with malignant SRM. Results: Our cohort consisted of 1726 patients with mean age 59.7 yrs. 61% (n=1045) were men, 90% (n=1,553) were white, 43% (n=736) had high ASA, 89% (1,540) underwent partial nephrectomy, 30% (n=525) had pCKD, 83% (n=1426) with malignant pathology and mean tumor size 2.5cm. On bivariable analysis patients with malignant SRM had a higher proportion of men (64.3 vs. 42.7%, p<0.001), high ASA class (43.8 vs. 37.3%, p=0.041) and larger tumors (2.6 vs. 2.3, p<0.001). There were no differences in age, race, mean eGFR or proportion with pCKD. On logistic regression analysis by gender factors associated with malignant pathology in women were high ASA class (OR 1.57, 95% CI 1.07−2.32) and tumor size (OR 1.48, 95% CI 1.20−1.81), and in men tumor size only (OR 1.33, 95% CI 1.06−1.67). Conclusions: Our results are in line with previous reports on the association of male gender and larger tumor size with malignant SRM. In addition we do show that among women those with poor health have a higher likelihood for having a malignant SRM.


2020 ◽  
Author(s):  
Wenwen Zheng ◽  
Zhiyu Zhang ◽  
Xilei Xie ◽  
Weiwei Zhu ◽  
Kangqi Li ◽  
...  

Abstract Background: The objective of this study was to investigate the prognostic value of tumor size on cancer-specific mortality (CSM) and lymph node metastasis for patients with penile squamous cell carcinoma (PSCC).Method: The patients diagnosed with PSCC between 2004 and 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Restricted cubic spline functions were calculated to characterize the association between tumor size and the risk of CSM. The competing-risks model was used to evaluate the impact of tumor size on the cumulative incidence of CSM. The logistic regression analysis was performed to examine the association between tumor size and lymph node metastasis.Results: Totally, 1365 PSCC patients were analyzed, with 52.3% having tumors ≤30 mm, and 47.7% >30 mm. The restricted cubic splines showed that the risks of CSM increased as tumors enlarged. Following adjustment of competing events, the PSCC patients with tumors >30 mm were more likely to succumb to CSM in comparison with those with tumors ≤30 mm (hazard ratio [HR]=1.57, 95% confidence interval [CI]: 1.23-2.01, P<0.001). In subgroup analyses, tumor size >30 mm was significantly associated with an increased risk of CSM relative to tumor size ≤30 mm among patients with T1 (HR=1.56, 95%CI: 1.03-2.37, P=0.036) and T3 (HR=2.51, 95%CI: 1.41-4.45, P=0.002) classifications. On logistic regression analysis, tumors >30 mm were significantly associated with lymph node metastasis (odds ratio [OR]=1.46, 95% CI: 1.03-2.07, P=0.034).Conclusion: Larger tumors (>30 mm) were significantly associated with higher risks of CSM and increased likelihood of lymph node metastasis for PSCC patients, which could be integrated into the development of a staging system for penile cancer.


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