Introduction: To investigate prevalence and impact of incidental renal masses (IRM) accompanying increasing computed tomography (CT) work-up for symptomatic aortic valve stenosis (sAVS) of the elderly with regard to the relevance of urological consultation for overall survival (OS).
Methods: A retrospective analysis of pre-transcatheter aortic-valve implantations (TAVI) CT scans of patients with sAVS (N=1253) harboring IRM was performed for 2014-2019. According to the clinical management, groups 1 (urologic consultation) and 2 (findings ignored) were formed and analyzed in terms of OS.
Results: The prevalence of IRM was 9% (119/1253). In 19% (23/119) urological advice was sought (group 1). At baseline, group 1 showed a significantly higher rate of malignancy-specific lesions compared to 2 (p<0.01). Other clinical parameters (e.g. age, cardiological scores, comorbidities) did not differ between groups (p>0.05). In group 1, 4 (17%) findings were histologically confirmed, of which 3 (13%) underwent surgery. There was no significant difference in median OS at a median follow-up of 24.7 months between group 1 and 2 with 35.7 (95%-CI, 5.9; 65.4] and 47.4 months (95%-CI [33.0; 61.7], respectively (p=0.4). In Cox regression analysis, chronic kidney disease but not urologic work-up or chronic obstructive pulmonary disease or heart failure emerged as an independent unfavorable predictor of OS (HR 2.44, 95% CI 1.37; 4.36, p=0.003).
Conclusion: For the first time, a TAVI population with IRM was analyzed from the urologist's perspective. Urologic co-evaluation and work-up does not confer a significant benefit in terms of OS in this particular population.
S. Karger AG, Basel.