The impact of a multidisciplinary small renal mass clinic on patient treatment decisions

Authors

  • Danielle Earis College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
  • Chris Wall Department of Diagnostic Imaging, Division of Interventional Radiology, University of Saskatchewan, Saskatoon, SK, Canada
  • Nicolette Sinclair Department of Diagnostic Imaging, Division of Interventional Radiology, University of Saskatchewan, Saskatoon, SK, Canada
  • Trustin Domes Department of Surgery, Division of Urology, University of Saskatchewan, Saskatoon, SK, Canada
  • Kunal Jana Department of Surgery, Division of Urology, University of Saskatchewan, Saskatoon, SK, Canada

DOI:

https://doi.org/10.5489/cuaj.7307

Keywords:

small renal mass, multidisciplinary

Abstract

Introduction: Small renal masses (SRMs) are managed with active surveillance (AS), thermal ablation (TA), irreversible electroporation (IRE), or surgery, depending on patient and tumor factors. A novel SRM multidisciplinary clinic (SRMC), involving urologists and interventional radiologists, was established to provide patients with information on treatments options. The objective of this study was to evaluate the impact of the SRMC on treatment decision-making.

Methods: Demographics, tumor characteristics, and treatment decisions were prospectively collected on patients (n=216) attending the SRMC between 2016 and 2019. A retrospective historic cohort (n=238) seen by urologists was used as a control group. Key variables were analyzed and compared. Patient satisfaction (n=27) was surveyed and responses were summarized and explored.

Results: Mean age, tumor size, and pathology was similar between groups; however, the SRMC cohort had more male patients (65.7% vs. 53.8%, p=0.009). Chosen treatment modality differed significantly between cohorts (p<0.0001). Patients in the historic cohort were treated by AS (41.5%), surgery (37.9%), TA (11.9%), watchful waiting (7.9%), and IRE (0.8%). SRMC patients were treated by TA (42.2%), AS (26.7%), surgery (21.3%), IRE (7.6%), and watchful waiting (2.2%). Post-hoc analysis revealed statistically significant differences in proportions of AS, TA, IRE, and surgery between cohorts. Patients reported high satisfaction with the collaborative approach.

Conclusions: A multidisciplinary approach may have an impact on patient treatment decision-making for SRMs. Consultations involving a urologist and an interventional radiologist resulted in more TA and IRE and less AS and surgery. Future studies should evaluate if these findings occur in other centers.

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Published

2021-06-03

How to Cite

Earis, D., Wall, C., Sinclair, N., Domes, T., & Jana, K. (2021). The impact of a multidisciplinary small renal mass clinic on patient treatment decisions. Canadian Urological Association Journal, 16(2), 35–40. https://doi.org/10.5489/cuaj.7307

Issue

Vol. 16 No. 2 (2022): CUAJ February

Section

Original Research

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