Active surveillance for clinically localized renal tumors: An updated review of current indications and clinical outcomes

International Journal of Urology : Official Journal of the Japanese Urological Association
M BorghesiR Schiavina

Abstract

The widespread use of abdominal imaging has led to an increasing detection of small renal masses, and approximately 20-30% of those tumors will prove to be benign, with low metastatic potential if not immediately treated. In elderly or comorbid patients diagnosed with small renal masses, competing cause mortality seems to exceed cancer-specific mortality at short- and intermediate-term follow up. In these cases, surgery might represent an overtreatment, and an expectant management, such as active surveillance, might be proposed. According to the current available evidence, active surveillance is a safe and reasonable option for patients with renal tumors ≤4 cm (cT1a) and short life expectancy. A few studies with short-term follow up reported the preliminary results of active surveillance even in cT1b-cT2 tumors, with acceptable risk of disease progression and mortality, even if this approach should be considered in this setting only for highly-selected and well-informed patients. Furthermore, surveillance protocols can be proposed in selected patients with uncomplicated benign tumors, such as angiomyolipomas, in which active surveillance should be considered the initial standard management. At present, reliable clinical predict...Continue Reading

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Dec 31, 2015·Current Urology Reports·Tania González León, Maricela Morera Pérez
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