Abstract
Increased abdominal imaging has led to the significant incidental detection of clinically localized renal tumors. While the gold standard remains surgical excision, no demonstrable improvement in cancer-specific mortality has been observed, implying that a proportion of small renal masses (SRMs) may be indolent tumors that do not require surgical intervention. As a result, active surveillance (AS) has emerged as an alternative management strategy in select elderly or comorbid patients with significant competing risks. Although the contemporary literature characterizing the natural history of untreated renal tumors is limited, recent data demonstrate that the majority of SRMs demonstrate slow growth kinetics with low rates of metastatic progression while under observation. Prospective trials are necessary to define entry and intervention criteria for contemporary AS protocols.
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Smaldone, M.C., Canter, D., Kutikov, A., Uzzo, R.G. (2013). Active Surveillance of the Small Renal Mass. In: Campbell, S., Rini, B. (eds) Renal Cell Carcinoma. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-062-5_10
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