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The evolving management of small renal masses
Yuzhi Wang1, Mohit Butaney1, Samantha Wilder1
1Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.
Nature Reviews. Urology
|February 16, 2024
Summary
Diagnosing small renal masses (SRMs) remains challenging despite advances in imaging. Management is shifting towards active surveillance and kidney-sparing surgery for these tumors.
Area of Science:
- Urology
- Oncology
- Radiology
Background:
- Small renal masses (SRMs) are increasingly detected incidentally due to improved abdominal imaging.
- Accurate pre-treatment diagnosis of malignancy in SRMs remains a significant clinical challenge.
- Current management trends favor nephron-sparing approaches over radical nephrectomy.
Purpose of the Study:
- To review the evolving landscape of small renal mass management.
- To highlight challenges in pre-treatment diagnosis of SRMs.
- To discuss the role of emerging technologies in understanding SRM biology and treatment.
Main Methods:
- Review of current literature on small renal mass diagnosis and management.
- Analysis of trends in treatment strategies, including active surveillance and nephron-sparing surgery.
- Exploration of advancements in biomarkers, imaging, and machine learning for SRM evaluation.
Main Results:
- Early detection of asymptomatic, organ-confined SRMs is common.
- Nephron-sparing surgery and active surveillance are now primary treatment modalities.
- Biomarkers, advanced imaging, and machine learning show potential for improved diagnostic accuracy and management.
Conclusions:
- Optimal management strategies for SRMs are continually evolving.
- Further research is needed to fully leverage new technologies for better patient outcomes.
- Understanding SRM heterogeneity is key to personalized treatment approaches.
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