An increasing number of enhancing renal masses are being discovered incidentally on cross-sectional imaging. Many can be characterized as small renal masses (SRMs), the natural history of which is heterogeneous and poorly understood. Active surveillance has been proposed as an initial management strategy for these tumors, particularly in the old and infirmed patient population. Herein, a rigorous review of the literature is provided to explore the incidence and epidemiology of SRMs as well as the growth kinetics and oncologic outcomes of SRMs under observation. Special consideration is given to competing risks to mortality and cost-analyses for the management of the SRM. Finally, the role of percutaneous biopsy and current prospective clinical trials of active surveillance for SRMs are reviewed.
Anti-cancer agents in medicinal chemistry. 2017 Nov 13 [Epub ahead of print]
Benjamin T Ristau, Thomas W Fuller, Ricardo Rios, Cristina Ho, Jeffrey J Tomaszewski
Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, PA. United States., Division of Urology, Department of Surgery, MD Anderson Cancer Center at Cooper, Cooper Medical School of Rowan University, Camden, NJ. United States.