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Point-of-Care Kidney and Genitourinary Ultrasound in Adults: Image Acquisition
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Active surveillance for small renal masses

Phillip M Pierorazio1, Elias S Hyams, Jeffrey K Mullins

  • 1Brady Urological Institute, Johns Hopkins University Baltimore, MD.

Reviews in Urology
|November 23, 2012
PubMed

Insights

Active surveillance is a safe option for small renal masses (SRMs), with less than 2% progressing to metastatic disease. This approach is suitable for patients who are not candidates for surgery.

Area of Science:

  • Urology
  • Oncology
  • Nephrology

Background:

  • Small renal masses (SRMs) incidence has increased, creating management challenges.
  • SRMs are biologically diverse, with multiple treatment options and good oncologic outcomes.

Purpose of the Study:

  • To review current data on active surveillance (AS) for SRMs.
  • To discuss operational considerations for implementing an AS program.
  • To outline criteria for patient selection for AS.

Main Methods:

  • Review of retrospective and prospective studies on AS for SRMs.
  • Analysis of oncologic outcomes and progression rates.
  • Evaluation of patient selection criteria and program logistics.

Main Results:

  • AS is a viable option for SRMs, especially for patients avoiding surgery.
  • Less than 2% of patients on AS progressed to metastatic disease in reviewed studies.
  • Established criteria allow for safe patient selection for AS.

Conclusions:

  • Active surveillance is a safe and effective strategy for select patients with small renal masses.
  • Careful patient selection and program management are crucial for successful AS.
  • AS offers a valuable alternative to immediate intervention for SRMs.
Keywords:
Active surveillanceRenal cell carcinomaSmall renal mass

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