{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T13:55:24Z","timestamp":1779112524572,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T00:00:00Z","timestamp":1397606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2014,9]]},"abstract":"\n Objective<\/jats:title>\n \n To present the outcomes of active surveillance (\n AS<\/jats:styled-content>\n ) for renal angiomyolipomas (\n AMLs<\/jats:styled-content>\n ) and to assess the clinical features predicting delayed intervention of this treatment option.\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n We retrospectively reviewed the outcomes of patients diagnosed with\n AMLs<\/jats:styled-content>\n on computed tomography (\n CT<\/jats:styled-content>\n ) who were managed with\n AS<\/jats:styled-content>\n at our institution. The\n AS<\/jats:styled-content>\n protocol consisted of 6\u2010 and 12\u2010month, then annual follow\u2010up visits, each one including a physical examination and\n CT<\/jats:styled-content>\n imaging. Discontinuation of\n AS<\/jats:styled-content>\n was defined as the need or decision for an active procedure during the follow\u2010up period. Causes of delayed intervention, as well as the type of active treatment (\n AT<\/jats:styled-content>\n ), were recorded. Clinical features at presentation of patients failing\n AS<\/jats:styled-content>\n were compared with those who remained under\n AS<\/jats:styled-content>\n at the time of the last follow\u2010up. Predictive factors of delayed intervention were analysed using univariate and multivariate\n C<\/jats:styled-content>\n ox regression models.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Overall, 130 patients were included in the analysis, of whom 102 (78.5%) were incidentally diagnosed, while 15 (11.5%) and 13 patients (10%) presented with flank pain and haematuria, respectively. After a mean (\n sd<\/jats:sc>\n ) follow\u2010up of 49 (40) months, 17 patients (13%) discontinued\n AS<\/jats:styled-content>\n and underwent\n AT<\/jats:styled-content>\n . Patients who underwent delayed intervention were more likely to present with a higher body mass index, larger tumours and symptomatic disease. Angioembolization represented the first\u2010line\n AT<\/jats:styled-content>\n after\n AS<\/jats:styled-content>\n (64.7%), whereas partial nephrectomy was adopted in 29.4% of patients. On the univariate analysis, risk factors for delayed intervention included tumour size \u22654\u2009cm, symptoms at diagnosis, and history of concomitant or contralateral kidney disease. On the multivariate analysis, only tumour size and symptoms remained independently associated with discontinuation of\n AS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Tumour size and symptoms at initial presentation were highly predictive of discontinuation of\n AS<\/jats:styled-content>\n in the management of\n AMLs<\/jats:styled-content>\n . Selective angioembolization was the first\u2010line option used for\n AT<\/jats:styled-content>\n after\n AS<\/jats:styled-content>\n was discontinued.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.12604","type":"journal-article","created":{"date-parts":[[2013,12,10]],"date-time":"2013-12-10T08:06:39Z","timestamp":1386662799000},"page":"412-417","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":75,"title":["Active surveillance for renal angiomyolipoma: outcomes and factors predictive of delayed intervention"],"prefix":"10.1111","volume":"114","author":[{"given":"Idir","family":"Ouzaid","sequence":"first","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Autorino","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Fatica","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian R.","family":"Herts","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH USA"},{"name":"Imaging Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon","family":"McLennan","sequence":"additional","affiliation":[{"name":"Imaging Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erick M.","family":"Remer","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH USA"},{"name":"Imaging Institute Cleveland Clinic Foundation Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georges\u2010Pascal","family":"Haber","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Foundation Cleveland OH 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