{"doi":"10.1111/bju.16651","title":"Tumour size is associated with growth rates of &gt;0.5 cm/year and delayed intervention in small renal masses in patients on active surveillance","abstract":"OBJECTIVE: To evaluate the association between tumour size and the growth rate (GR) of small renal masses (SRMs) in patients managed by active surveillance (AS). MATERIALS AND METHODS: We queried the prospective, multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry for patients on AS with an imaging interval of ≥6 months, identifying 456 patients. We tracked tumour size over time; a GR >0.5 cm/year was defined as a GR event. We used multivariable recurrent events and time-to-event Cox regression modelling to evaluate the association between tumour size and GR events (primary outcome) and tumour size and delayed intervention (DI; secondary outcome). We tested tumour size as a continuous variable and dichotomised tumour size by predefined (2-cm) and calculated (2.9-cm) cutoffs. We calculated the cutoff using maximally selected rank statistics and time to progression, defined according to the DISSRM registry. RESULTS: The median (interquartile range) follow-up of patients on AS was 40.1 (26.4-71.2) months, during which 128 patients (28%) had ≥1 GR event, and 80 (18%) underwent DI. Larger tumour size was an independent predictor for GR events and DI when tested as a continuous and a dichotomous variable in multivariable analyses (all P < 0.05). The association was strongest when accounting for the change in tumour size over time and when applying the 2.9-cm cutoff. The study is limited by the mixed tumour pathology inert to SRMs. CONCLUSION: Larger tumour size was independently associated with GR events and DI for patients with SRMs on AS. A 2.9-cm cutoff may provide valuable information for patient counselling.","journal":"British Journal of Urology","year":2025,"id":518933,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7851,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1199446,"name":"Michael E. Rezaee","orcid":"0000-0002-6236-8682","position":1,"is_corresponding":false},{"id":334482,"name":"Roy Elias","orcid":"0000-0002-8555-4322","position":2,"is_corresponding":false},{"id":1387300,"name":"Tina Wlajnitz","orcid":null,"position":3,"is_corresponding":false},{"id":1386844,"name":"Sean A. Fletcher","orcid":"0009-0009-4874-3552","position":4,"is_corresponding":false},{"id":485998,"name":"Joseph Cheaib","orcid":"0000-0003-1679-2682","position":5,"is_corresponding":false},{"id":1387301,"name":"Khalid Alkhatib","orcid":null,"position":6,"is_corresponding":false},{"id":717899,"name":"Peter Chang","orcid":"0000-0003-3971-2630","position":7,"is_corresponding":false},{"id":778130,"name":"Andrew A. Wagner","orcid":"0000-0002-1832-1983","position":8,"is_corresponding":false},{"id":665451,"name":"James M. McKiernan","orcid":null,"position":9,"is_corresponding":false},{"id":272254,"name":"Mohamad E. Allaf","orcid":"0000-0003-3333-3904","position":10,"is_corresponding":false},{"id":531964,"name":"Phillip M. Pierorazio","orcid":"0000-0003-0766-9981","position":11,"is_corresponding":false},{"id":352923,"name":"Nirmish Singla","orcid":"0000-0001-9495-6983","position":12,"is_corresponding":false},{"id":1386843,"name":"Maximilian Pallauf","orcid":"0000-0002-8496-4506","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T02:49:14.184995Z","pmid":"39873312","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}