Özet:

Purpose: In the preoperative assessment of small (≤4 cm) solid renal masses, we looked at the predictive value of the additional clinical parameters that can be used to make a benign-malign distinction, to identify patients who should be avoided from surgeons that will result in unnecessary nefron loss. Methods: Between September 2009 and December 2017, the data of 56 patients with a partial or radical nefrectomy with a pre-diagnosis of localized renal cell carcinoma ≤4 cm were examined retrospective. Demographic data of patients, histopathological tumor types, neutrophil/lenfocyt ratio (NLO), monocyt/lenfocyt ratio (MLO), platelet/lenfocyt ratio (PLO), average platelet volume (MPV), erythrosite distribution width (RDW), Framingham risk score and the presence of components that predict the development of 10 years of cardiovascular disease and mortality risk, postoperative tracking data were recorded. According to the tumor histopathology, patients were compared by dividing into two groups, benign and malign. Results: 13 of 56 patients with an average diagnosed age of 60 (min: 35-max: 74) had benign, 43 had malignant pathology. MLO (p=0.011), NLO (p=0.032), PLO (p=0.006), MPV (p=0.025) and eGFR (p=0.019) are significantly high in the malign group; RDW (p=0.396) does not see any difference between the groups. In malign cases, Framingham’s score was higher (p=0.008); in the components that made this risk score, only smoking (p=0.032), hypertension (p=0.041), total cholesterol (p=0.021) were significantly higher. Following the calculation of the cut values according to the ROC analysis, in the multi-variable analysis, NLO>2.02 (OR: 7.184, p=0.037), PLO>109.65 (OR: 12.692, p=0.002), MPV>3.44 (OR: 10.543, p=0.046) and Framingham score>10.5 (OR: 12.287, p=0.007) were determined as predictive factors in making benign-malign distinction in small solid renal masses. In the clinical assessment of small solid renal masses, where malignity distinction is not clearly done, we consider that by increasing the predictive power of using the NLO, PLO, MPV and Framingham scores, we can prevent unnecessary nefron loss in benign masses. (SETB-2019-04-063)

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