Evolving horizons in renal angiomyolipoma: two decades of management strategies and clinical perspectives in a single institutional study

* The preliminary results of this study were presented as a podium presentation at the 38th Annual European Association of Urology (EAU 23) Congress in Milan.

Figures & data

Figure 1. Study flow diagram.

Table 1. The comparison of patients demographics between surveillance and intervention groups.

Variable	Category	Total, n (%) (n = 203)	Surveillance, n (%) (n = 144)	Intervention, n (%) (n = 59)	p Value
Gender	Male	47 (23.2)	28 (59.6)	19 (40.4)	0.05*
	Female	156 (76.8)	116 (74.4)	40 (25.6)
Age at diagnosis (yr)	Median (min–max)	62 (14–90)	63 (14–90)	61 (25–83)	0.662**
BMI (kg/m^2)	Median (min–max)	28 (19.8–40)	28 (20–35)	27.3 (19.8–40)	0.668**
Side	Right kidney	89 (43.8)	61 (68.5)	28 (31.5)	0.358*
	Left kidney	108 (53.2)	80 (74.1)	28 (25.9)
	Bilateral	6 (3)	3 (50)	3 (50)
Clinical presentation	Incidental	148 (72.9)	121 (81.8)	27 (18.2)	<0.001*
	Symptomatic	22 (10.8)	23 (41.8)	32 (58.2)	<0.001*
Symptom type ^Ψ	Hematuria/bleeding	19 (26.8)	8 (42.1)	11 (57.9)	<0.001*
	Pain	52 (73.2)	22 (42.3)	30 (57.7)	0.004*
ABO blood group antigen	0 group	68 (33.5)	53 (77.9)	15 (22.1)	0.006*
	A group	95 (46.8)	62 (65.3)	33 (34.7)
	B group	23 (11.3)	12 (52.2)	11 (47.8)
	AB group	17 (8.4)	10 (58.8)	7 (41.2)
Size of the lesion at baseline (cm)	Median (min–max)	2 (0.5–2.3)	1.5 (0.5–19)	5 (1.1–23)	<0.001**
Size of the lesion at baseline (cm)	≤2	109 (53.7)	102 (93.6)	7 (6.4)	<0.001*
	>2 to ≤4	33 (16.3)	20 (60.6)	13 (39.4)
	>4 to ≤6	26 (12.8)	12 (46.2)	14 (53.8)
	>6	35 (17.2)	10 (28.6)	25 (71.4)

Significant p values are in bold; *Chi-square test p value; **Mann–Whitney U test p value.

BMI; body mass index; yr: year; Ψ: 16 patients had both symptoms.

Table 2. The coefficients of the significant variables in the multivariate logistic regression analysis for the prediction of the intervention.

Variables	Category	β	S.E	Wald	Sig.	OR (95% CI)
ABO blood group antigen	O group (R)			1.897	0.594
	A group	0.536	0.455	1.388	0.239	1.71 (0.7–4.174)
	B group	0.75	0.652	1.32	0.251	2.116 (0.589–7.602)
	AB group	−19.656	8697.608	0	0.998	0
Clinical presentation	Incidental (R)
	Symptomatic	1.22	0.425	8.251	0.004	3.387 (1.473–7.786)
Size of the lesion at baseline (cm)	≤2 (R)			34.514	<0.001
	>2 to ≤4	2.12	0.562	14.244	<0.001	8.331 (2.771–25.051)
	>4 to ≤6	2.743	0.59	21.64	<0.001	15.538 (4.891–49.357)
	>6	2.997	0.563	28.352	<0.001	20.024 (6.645–60.346)
Constant		−5.208	2174.402	0	0.998	0.005

S.E: standard error; R: reference group; OR: odds ratio; CI: confidence interval. Bold font indicates statistical significance.

Figure 2. Changing strategies for renal angiomyolipoma management over time.

Data availability statement

The datasets are available from the corresponding author.