Available active surveillance follow-up protocols for small renal mass: a systematic review

Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients.Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012.Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47–89). The mean follow-up period was 34 months (12–112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery.Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

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Laparoscopic Versus Percutaneous Cryoablation of Small Renal Mass: Systematic Review and Cumulative Analysis of Comparative Studies

Clinical Genitourinary Cancer ◽

10.1016/j.clgc.2017.02.003 ◽

2017 ◽

Vol 15 (5) ◽

pp. 513-519.e5 ◽

Cited By ~ 8

Author(s):

Rodrigo R. Pessoa ◽

Riccardo Autorino ◽

M. Pilar Laguna ◽

Wilson R. Molina ◽

Diedra Gustafson ◽

...

Keyword(s):

Systematic Review ◽

Comparative Studies ◽

Renal Mass ◽

Small Renal Mass ◽

Percutaneous Cryoablation

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The Overdiagnosis of Kidney Cancer in Koreans and the Active Surveillance on Small Renal Mass

The Korean Journal of Urological Oncology ◽

10.22465/kjuo.2018.16.1.15 ◽

2018 ◽

Vol 16 (1) ◽

pp. 15-24

Author(s):

Byung Hoon Chi ◽

In Ho Chang

Keyword(s):

Kidney Cancer ◽

Active Surveillance ◽

Renal Mass ◽

Small Renal Mass

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Active Surveillance for the Small Renal Mass

Urologic Clinics of North America ◽

10.1016/j.ucl.2016.12.007 ◽

2017 ◽

Vol 44 (2) ◽

pp. 213-222 ◽

Cited By ~ 9

Author(s):

Benjamin T. Ristau ◽

Andres F. Correa ◽

Robert G. Uzzo ◽

Marc C. Smaldone

Keyword(s):

Active Surveillance ◽

Renal Mass ◽

Small Renal Mass

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18F-FDG PET-CT Findings Before and After Laparoscopic Cryoablation of Small Renal Mass: An Initial Report

Journal of Kidney Cancer and VHL ◽

10.15586/jkcvhl.2015.42 ◽

2015 ◽

Vol 2 (4) ◽

pp. 174-186 ◽

Cited By ~ 1

Author(s):

Brunolf Walther Lagerveld ◽

Ferida Sivro ◽

Johan A. Van der Zee ◽

Phillippe C Baars

Keyword(s):

Fdg Pet ◽

Renal Mass ◽

Bone Lesions ◽

Small Renal Mass ◽

Initial Report ◽

Pet Ct ◽

Before And After ◽

18F Fdg ◽

Fdg Pet Ct

The aim of this study was to describe the characteristics of positron emission tomography (PET) molecular imaging combined with low-dose computed tomography (CT) in small renal mass (SRM) treated with cryoablation (CA). Currently, treatment success is defined by the absence of contrast enhancement at CT. However, the use of contrast is relatively contraindicated in patients with renal function impairment, mandating alternative follow-up strategies. Several reasons were identified as criteria for performing PET-CT before and/or after SRM-CA in 9 patients, and the results were retrospectively studied. The histology revealed renal cell carcinoma in 7 patients andoncocytoma in 2 patients. In 6 patients, a PET-CT was performed before and after CA. In one patient, the PET-CT was performed only before CA and in 2 patients only after CA. Before CA, clearly there was metabolic uptake of fluorine-18 fluorodeoxyglucose (18F-FDG) in the SRM in all patients. Following CA, the absence of 18F-FDG uptakes in the SRM could clearly be noticed. However, the tracer cannot always be distinguished from focal recurrence or reactive inflammatory tissue. In one patient, asymptomatic metastatic bone lesions were noticed when performing PET-CT at follow-up. This pilot study with 18F-FDG PET-CT for the follow-up of SRM cryosurgery showed that 18F-FDG PET-CT imaging could be used to characterize cryoablative tissue injury at different times after CA.

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Active surveillance for bilateral renal oncocytomas already resected on one side: a case report

Urologia Journal ◽

10.1177/0391560320978038 ◽

2020 ◽

pp. 039156032097803

Author(s):

Mangano Mario S ◽

Cicerello Elisa ◽

Cova Gian D ◽

Ciaccia Matteo ◽

Tomasi Biagio

Keyword(s):

Partial Nephrectomy ◽

Active Surveillance ◽

Renal Mass ◽

Laparoscopic Partial Nephrectomy ◽

Resonance Imaging ◽

Minimal Growth ◽

Renal Oncocytomas ◽

Renal Biopsies ◽

Magnetic Resonance Imaging Mri

Introduction: To report our experience of active surveillance of new bilateral masses after left laparoscopic partial nephrectomy for oncocytoma. Method: A 67-year old man underwent left laparoscopic partial nephrectomy for a renal mass and histology confirmed oncocytoma. At follow-up magnetic resonance imaging (MRI) showed new renal bilateral masses: hence, sonogram-guided percutaneous core renal biopsies were performed confirming the presence of oncocytoma in both kidneys. A re-biopsy was required because of an increasing of the left mass while a histological was also consistent with oncocytoma. Result: At follow of 8 years the patient is well and shows a normal renal function. Conclusion: Oncocytomas show minimal growth rate or progression. MRI has an important role in the appropriate follow-up of renal oncocytomas. Patients with biopsy proven oncocytoma may be managed conservatively by active surveillance (AS).

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Latest Evidence on the Role of Multiparametric Magnetic Resonance Imaging in Active Surveillance for Insignificant Prostate Cancer: A Systematic Review

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520618666180105105413 ◽

2018 ◽

Vol 18 (7) ◽

pp. 925-930 ◽

Cited By ~ 3

Author(s):

Francesco Cantiello ◽

Stefano Manno ◽

Giorgio I. Russo ◽

Sebastiano Cimino ◽

Salvatore Privitera ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Systematic Review ◽

Magnetic Resonance ◽

Active Surveillance ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging ◽

Clinically Significant

Objective: Multiparametric Magnetic Resonance Imaging (mpMRI) has become a very useful tool in the management of PCa. Particularly, there is a great interest in using mpMRI for men on Active Surveillance (AS) for low risk PCa. The aim of this systematic review was to critically review the latest literature concerning the role of mpMRI in this clinical setting, underlying current strengths and weakness. Evidence Acquisition: A comprehensive literature research for English-language original and review articles was carried out using the National Center for Biotechnology Information PubMed database with the aim to identify studies pertaining to mpMRI for AS in low risk PCa patients. The following search terms were used: active surveillance, prostate cancer and multiparametric magnetic resonance imaging. Evidence Synthesis: Data from 28 recent original studies and reviews were reviewed. We only considered studies on the use of mpMRI in selecting AS patients and during AS follow-up, in order to solve two important questions: -Can mpMRI have a role in improving the detection of clinically significant disease, better selecting AS patients? -Can mpMRI identify the progression of disease and, consequently, be used during AS follow-up? Conclusions: mpMRI is useful to better select the ideal candidates to AS and to monitor them during follow-up. However, despite many advantages, there are yet important limitations to detect all clinically significant PCa and to better define mpMRI-radiological progression during AS. Further larger prospective studies are needed to definitively solve these important problems.

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Management of Small Renal Masses

10.2310/tywc.11094 ◽

2018 ◽

Author(s):

Keith A Lawson ◽

Antonio Finelli

Keyword(s):

Natural History ◽

Renal Mass ◽

The Body ◽

Renal Tumors ◽

Small Renal Mass ◽

Small Renal Masses ◽

Tumor Biopsy ◽

Renal Masses ◽

History Of

The rise in incidentally discovered enhancing solid renal tumors has spurred the development of new approaches to managing this unique clinical entity known as the small renal mass (SRM). These approaches are grounded on a better understanding of the natural history of SRM, with the goal to reduce the morbidity associated with their management and avoid overtreatment. In this chapter, we review the body of evidence pertaining to the classification and clinical management of SRMs with respect to diagnosis, treatment, and follow-up. In addition, we discuss the controversies and active areas of development for this rapidly evolving field that strides towards a precision medicine paradigm. This review contains 6 figures, 6 tables and 63 references Keywords: Small renal mass, renal cell carcinoma, radical nephrectomy, renal tumor biopsy, active surveillance, natural history, oncocytoma, robotic surgery, partial nephrectomy

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