The Role of Ablation and Minimally Invasive Techniques in the Management of Small Renal Masses.

Nephron-sparing approaches are increasingly recommended for incidental small renal masses. Herein, we review the current literature regarding the safety and efficacy of focal therapy, including percutaneous ablation, for small renal masses.

To summarize the application of ablative therapy in the management of small renal masses.

PubMed and Medline database search was performed to look for findings published since 2000 on focal therapy for small renal masses. After literature review, 64 articles were selected and discussed.

Radiofrequency ablation and cryotherapy are the most widely used procedures with intermediate-term oncological outcome comparable with surgical series. Cost effectiveness seems excellent and side effects appear acceptable. To date, no randomized trial comparing percutaneous focal therapy with standard surgical approach or active surveillance has been performed.

Focal ablative therapies are now accepted as effective treatment for small renal tumors. For tumors <3cm, oncological effectiveness of ablative therapies is comparable with that of partial nephrectomy. Percutaneous ablation has fewer complications and a better postoperative profile when compared with minimally invasive partial nephrectomy.

Focal ablative therapies are now accepted as effective treatment for small renal tumors. For tumors <3cm, oncological effectiveness of ablative therapies is comparable with that of partial nephrectomy.

European urology oncology. 2018 Sep 24 [Epub]

Maciej Salagierski, Adrianna Wojciechowska, Kinga Zając, Tobias Klatte, R Houston Thompson, Jeffrey A Cadeddu, Jihad Kaouk, Riccardo Autorino, Kamran Ahrar, Umberto Capitanio, Young Academic Urologists Kidney Cancer Working Group of the European Urological Association

Urology Department, The Faculty of Medicine and Health Sciences, University of Zielona Góra, Zielona Góra, Poland. Electronic address: ., Urology Department, The Faculty of Medicine and Health Sciences, University of Zielona Góra, Zielona Góra, Poland., Department of Urology, Royal Bournemouth and Christchurch Hospitals, Bournemouth, UK., Department of Urology, Mayo Clinic, Rochester, NY, USA., Department of Urology, UT Southwestern Medical Center, TX, USA., Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA., Division of Urology, VCU Health, Richmond, VA, USA., Interventional Radiology, The University of Texas MD Anderson Cancer Center, TX, USA., Unit of Urology, Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy.