Exploring Management Preferences Among Patients with Small Renal Masses: Results from a Pilot Study.

Area of Science:

• Urology
• Oncology
• Medical Decision Making

Background:

• Small renal masses (SRMs) are often treated definitively, but active surveillance is an alternative.
• Patient preferences for SRM management are not fully understood.
• Understanding patient preferences is crucial for shared decision-making in SRM treatment.

Purpose of the Study:

• To determine patient preferences for managing small renal masses (SRMs).
• To compare patient preferences between definitive treatments like thermal ablation and partial nephrectomy.
• To assess patient willingness to accept increased mortality risk for avoiding definitive treatment.

Main Methods:

• A multicenter prospective pilot study involving structured online interviews with 41 new SRM patients.
• Patients reviewed outcome data and expressed preferences for thermal ablation versus partial nephrectomy.
• Hypothetical scenarios were used to determine the acceptable increase in mortality risk to decline treatment.

Main Results:

• 71% of patients preferred thermal ablation over partial nephrectomy.
• The median acceptable increase in 5-year cancer death probability to decline treatment was 0.1%.
• 97% of patients preferred risk data presented as a reduction in mortality risk.

Conclusions:

• This pilot study confirms the feasibility of assessing patient preferences for SRM management.
• A strong patient preference exists for thermal ablation and for presenting risk data in terms of mortality reduction.
• Larger studies are needed to validate these findings and inform clinical practice.