The wide spread utilization of abdominal imaging has led to an increasing incidence of small renal masses (SRMs) characteristic for renal cell carcinoma. However, at least 20% are benign. Nevertheless, nephron-sparing surgery is considered the standard treatment for these SRMs without pretreatment characterization with biopsy. As well, many patients are elderly patients and have multiple comorbidities with limited life expectancy. We now know that these patients may safely be managed with active surveillance (AS) with a low risk of disease progression and disease specific mortality. An initial period of observation to determine tumor growth kinetics is safe and appropriate in select candidates. Renal tumor biopsy (RTB) is accurate and safe and should be considered for all patients with SRMs prior to finalizing treatment plans.
Urology. 2016 Jul 07 [Epub ahead of print]
Ardalan E Ahmad, Antonio Finelli, Michael A S Jewett
Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada., Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada., Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada. Electronic address: .