Rand N Wilcox Vanden Berg1, Spyridon P Basourakos1, Samuel LaRussa2,3, Timothy D McClure4,5. 1. Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA. 2. Department of Radiology, Einstein-Jacobi Medical Center, Bronx, NY, USA. 3. Department of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA. 4. Department of Urology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA. tim9047@med.cornell.edu. 5. Department of Interventional Radiology, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA. tim9047@med.cornell.edu.
Abstract
PURPOSE OF REVIEW: Small renal masses (≤ cT1a, less than 4 cm) are a subset of renal tumors with low malignant and metastatic potential but increasing incidence given increased use of cross-sectional imaging. Here, we review the diagnostic and treatment options available for the lesions. RECENT FINDINGS: While the low metastatic potential of SRMs has been known, recent studies show that 30% of SRMs removed surgically are benign. Renal biopsy is a tool that can be implemented to help with diagnosis before treatment (options of which include active surveillance, ablation, and surgery). Active surveillance might be associated with worse cancer-specific survival but all interventional methods appear to fare similarly. Advancements have also been made in percutaneous ablation techniques, and they now are included on multiple guideline statements. Active surveillance, surgery (PN and RN), and thermal ablation are all treatment options for SRMs with similar outcomes but varying side effects.
PURPOSE OF REVIEW: Small renal masses (≤ cT1a, less than 4 cm) are a subset of renal tumors with low malignant and metastatic potential but increasing incidence given increased use of cross-sectional imaging. Here, we review the diagnostic and treatment options available for the lesions. RECENT FINDINGS: While the low metastatic potential of SRMs has been known, recent studies show that 30% of SRMs removed surgically are benign. Renal biopsy is a tool that can be implemented to help with diagnosis before treatment (options of which include active surveillance, ablation, and surgery). Active surveillance might be associated with worse cancer-specific survival but all interventional methods appear to fare similarly. Advancements have also been made in percutaneous ablation techniques, and they now are included on multiple guideline statements. Active surveillance, surgery (PN and RN), and thermal ablation are all treatment options for SRMs with similar outcomes but varying side effects.
Entities:
Keywords:
Ablation; Active surveillance; Nephrectomy; Renal biopsy; Small renal mass
Authors: Flora E Rodger; Keiran Brown; Steve Leung; Jack Coode-Bate; James Armitage; Anne Warren; Jane Hendry; Grant D Stewart; Alex Laird; Grenville M Oades Journal: BJUI Compass Date: 2022-03-03