Skip to main content
SpringerLink
Log in

Management of Small Renal Masses

  • Chapter
  • First Online:
Genitourinary Cancers

Part of the book series: Cancer Treatment and Research ((CTAR,volume 175))

Abstract

With the ubiquitous use of cross-sectional abdominal imaging in recent years, the incidence of small renal masses (SRMs) has increased, and the evaluation and management of SRMs have become important clinical issues. Diagnosing a mass in the early stages theoretically allows for high rates of cure but simultaneously risks overtreatment. In the past 20 years, surgical treatment of SRMs has transitioned from radical nephrectomy for all renal tumors, regardless of size, to elective partial nephrectomy whenever technically feasible. Additionally, newer approaches, including renal mass biopsy, active surveillance for select patients, and renal mass ablation, have been increasingly used. In this chapter, we review the current evidence-based papers covering aspects of the diagnosis and management of SRMs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Siegel R, Miller KD, Jemal A (2015) Cancer statistics. CA Cancer J Clin 65:5–29

    Article  Google Scholar 

  2. Ljungberg B, Bensalah K, Canfield S et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol 67:913–924

    PubMed  Google Scholar 

  3. Howlader N, Noone A, Krapcho M, et al (2015) Seer Cancer Stat Rev. http://seer.cancer.gov/csr/1975_2013/

  4. Chow WH, Devesa SS (2008) Contemporary epidemiology of renal cell cancer. Cancer J 14:288–301

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Sanfilippo KM, McTique KM, Fidler CJ et al (2014) Hypertension and obesity and the risk of kidney cancer in 2 large cohorts of US men and women. Hypertension 63:934–941

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M (2008) Body mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371:569–578

    Google Scholar 

  7. Kato M, Suzuki T, Suzuki Y et al (2004) Natural history of small renal cell carcinoma: evaluation of growth rate, histological grade, cell proliferation and apoptosis. J Urol 172:863–866

    PubMed  Google Scholar 

  8. Sun M, Thuret R, Abdollah F et al (2011) Age-adjusted incidence, mortality, and survival rates of stage-specific renal cell carcinoma in North America: a trend analysis. Eur Urol 59:135–141

    PubMed  Google Scholar 

  9. Kocher KE, Meurer WJ, Fazel R et al (2011) National trends in use of computed tomography in the emergency department. Ann Emerg Med 58:452–462

    PubMed  Google Scholar 

  10. Luciani LG, Cestari R, Tallarigo C (2000) Incidental renal cell carcinoma-age and stage characterization and clinical implications study of 1092 patients (1982–1997). Urology 56:58–62

    CAS  PubMed  Google Scholar 

  11. Jayson M, Sanders H (1998) Increased incidence of serdenipitously discovered renal cell carcinoma. Urology 51:203–205

    CAS  PubMed  Google Scholar 

  12. Hock LM, Lynch J, Balaji KC (2002). Increasing incidence of all stages of kidney cancer in the last 2 decades in the United States: an analysis of surveillance, epidemiology and end results program data. J Urol 167:57–60

    PubMed  Google Scholar 

  13. Gill IS, Aron M, Gervais DA et al (2010) Clinical practice. Small renal mass. N Engl J Med 362:624–634

    CAS  PubMed  Google Scholar 

  14. Johnson DC, Vukina J, Smith AB et al (2015) Preoperatively misclassified, surgically removed benign renal masses: a systematic review of surgical series and United States population level burden estimate. J Urol 193:30–35

    PubMed  Google Scholar 

  15. Wendler JJ, Porsch M, Nitschke S et al (2015) A prospective phase 2a pilot study investigating focal percutaneous irreversible electroporation (IRE) ablation by NanoKnife in patients with localized renal cell carcinoma (RCC) with delayed interval tumor resection (IRENE trial). Contemp Clin Trials 43:10–19

    CAS  PubMed  Google Scholar 

  16. Kutikov A, Fossett LK, Ramchandhani P et al (2006) Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology 68:737–740

    PubMed  Google Scholar 

  17. Hollingsworth JM, Miller DC, Daignault S et al (2006) Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst 98:1331–1334

    PubMed  Google Scholar 

  18. Rendon RA, Stanietzky N, Panzarella T et al (2000) The natural history of small renal masses. J Urol 164:1143–1147

    CAS  PubMed  Google Scholar 

  19. O’Connor SD, Pickhardt PJ, Kim DH et al (2011) Incidental finding of renal masses at unenhanced CT: prevalence and analysis of features for guiding management. AJR Am J Roentgenol 197:139–145

    PubMed  Google Scholar 

  20. Finelli A, Ismaila N, Bro B et al (2017) Management of small renal masses: American society of clinical oncology clinical practice guideline. J Clin Oncol 35:668–680

    PubMed  Google Scholar 

  21. Marconi L, Dabestani S, Lam TB et al (2011) Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumor biopsy. Eur Urol 59:135–141

    Google Scholar 

  22. Israel GM, Bosniak MA (2005) How do I do it: evaluating renal masses. Radiology 236:441–450

    PubMed  Google Scholar 

  23. Zhang J, Lefkowitz RA, Ishill NM et al (2007) Solid renal cortical tumors: differentiation with CT. Radiology 244:494–504

    PubMed  Google Scholar 

  24. Jinzaki M, Tanimoto A, Mukai M et al (2000) Double-phase helical CT of small renal parenchymal neoplasms: correlation with pathologic findings and tumor angiogenesis. J Comput Assist Tomogr 24:835–842

    CAS  PubMed  Google Scholar 

  25. Pierorazio PM, Hyams ES, Tsai S et al (2013) Multiphasic enhancement patterns of small renal masses (<4 cm) on preoperative computed tomography: utility for distinguishing subtypes of renal cell carcinoma, angiomylipoma, and oncocytoma. Urology 81:1265–1272

    PubMed  PubMed Central  Google Scholar 

  26. Divgi CR, Uzzo RG, Gatsonis C et al (2013) Positron emission tomography/computed tomography identification of clear cell renal carcinoma: results from the REDECT trial. J Clin Oncol 31:187

    PubMed  Google Scholar 

  27. Gorin MA, Rowe SP, Baras AS et al (2016) Prospective evaluation of (99 m) Tc-sestamibi SPECT/CT for the diagnosis of renal oncocytomas and hybrid oncocytic/chromophobe tumors. Eur Urol 69:413–416

    PubMed  Google Scholar 

  28. Burruni R, Lhermitte B, Cerantola Y et al (2016) The role of renal biopsy in small renal masses. Can Urol Assoc J 10:E28–E33

    PubMed  PubMed Central  Google Scholar 

  29. Herts BR, Baker ME (1995) The current role of percutaneous biopsy in the evaluation of renal masses. Semin Urol Oncol 13:254–261

    CAS  PubMed  Google Scholar 

  30. Breau RH, Crispen PL, Jenkins SM, Blute ML, Leibovich BC (2011) Treatment of patients with small renal masses: a survey of the American urological association. J Urol 185:407–413

    PubMed  Google Scholar 

  31. Leppert JT, Hanley J, Wagner TH et al (2014) Utilization of renal mass biopsy in patients with renal cell carcinoma. Urology 185:407–413

    Google Scholar 

  32. Marconi L, Dabestani S, Lam TB (2016) Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumor biopsy. Eur Urol 69:660–673

    PubMed  Google Scholar 

  33. Richard PO. Jewett MA, Bhatt JR et al (2015) Renal tumor biopsy for small renal masses: a single-center 13-year experience. Eur Urol 68:1007–1013

    PubMed  Google Scholar 

  34. Mullins JK, Rodriguez R (2013) Renal cell carcinoma seeding of a percutaneous biopsy tract. Can Urol Assoc J 7:E176–E179

    PubMed  PubMed Central  Google Scholar 

  35. Leveridge MJ, Finelli A, Kachura JR et al (2011) Outcomes of small renal mass needle core biopsy, nondiagnostic percutaneous biopsy, and the role of repeat biopsy. Eur Urol 60:578–584

    PubMed  Google Scholar 

  36. Ball MW, Bezerra SM, Gorin MA et al (2015) Grade heterogeneity in small renal masses: potential implications for renal mass biopsy. J Urol 193:36–40

    PubMed  Google Scholar 

  37. Tomaszewski JJ, Uzzo RG, Smaldone MC (2014) Heterogeneity and renal mass biopsy: a review of its role and reliability. Cancer Biol Med 11:162–172

    PubMed  PubMed Central  Google Scholar 

  38. Conti A, Santoni M, Sotte V et al (2015) Small renal masses in the era of personalized medicine: tumor heterogeneity, growth kinetics, and risk of metastasis. Urol Oncol: Semin Original Inv 33:303–309

    Google Scholar 

  39. Campbell SC, Novick AC, Belldegrun A et al (2009) Guideline for management of the clinical T1 renal mass. J Urol 182:1271–1279

    PubMed  Google Scholar 

  40. Kutikov A, Egleston BL, Wong YN et al (2010) Evaluating overall survival and competing risks of death in patients with localized renal cell carcinoma using a comprehensive nomogram. J Clin Oncol 28:311

    PubMed  Google Scholar 

  41. Volpe A, Cadeddu JA, Cestari A et al (2011) Contemporary management of small renal masses. Eur Urol 60:501

    PubMed  Google Scholar 

  42. Shuch B, Hanley JM, Lai JC et al (2014) Adverse health outcomes associated with surgical management of the small renal mass. J Urol 191:301–308

    PubMed  Google Scholar 

  43. Smaldone MC, Kutikov A, Egleston BL et al (2012) Small renal masses progressing to metastases under active surveillance: a systematic review and pooled analysis. Cancer 118:997

    PubMed  Google Scholar 

  44. Crispen PL, Viterbo R, Boorjian SA et al (2009) Natural history, growth kinetics, and outcomes of untreated clinically localized renal tumors under active surveillance. Cancer 115:2844

    PubMed  PubMed Central  Google Scholar 

  45. Crispen PL, Uzzo RG (2007) The natural history of untreated renal masses. BJU Int 99:1203

    PubMed  Google Scholar 

  46. Abouassaly R, Lane BR, Novick AC (2008) Active surveillance of renal masses in elderly patients. J Urol 180:505

    PubMed  Google Scholar 

  47. Wehle MJ, Thiel DD, Petrou SP et al (2004) Conservative management of incidental contrast enhancing renal masses as safe alternative to invasive therapy. Urology 64:49

    PubMed  Google Scholar 

  48. Volpe A, Jewett MA (2007) The role of surveillance for small renal masses. Nat Clin Pract Urol 4:2–3

    PubMed  Google Scholar 

  49. Volpe A, Panzarella T, Rendon RA, Haider MA, Kondylis FI, Jewett MA (2004) The natural history of incidentally detected small renal masses. Cancer 100:738–745

    PubMed  Google Scholar 

  50. Abou Youssif T, Kassouf W, Steinberg J, Aprikian AG, Laplante MP, Tanguay S (2007) Active surveillance for selected patients with renal masses; updated results with long-term follow up. Cancer 110:1010–1014

    PubMed  Google Scholar 

  51. Mason RJ, Abdolell M, Trottier G et al (2011) Growth kinetics of renal masses analysis of a prospective cohort of patients undergoing active surveillance. Eur Urol 59:863–867

    PubMed  Google Scholar 

  52. Brunocilla E, Borghesi M, Schiavana R et al (2014) Small renal masses initially managed using active surveillance: results from a retrospective study with long-term follow up. Clin Genitourin Cancer 12:178–181

    PubMed  Google Scholar 

  53. Gontero P, Joniau S, Oderda M et al (2013) Active Surveillance for small renal tumors: have clinical concerns been addressed so far? Int J Urol 20:357–361

    Google Scholar 

  54. Mehrazin R, Smaldone MC, Kutikov A et al (2014) Growth kinetics and short-term outcomes of cT1b and cT2 renal masses under active surveillance. J Urol 192:659–664

    PubMed  PubMed Central  Google Scholar 

  55. Haramis G, Mues AC, Rosales JC et al (2011) Natural history of renal cortical neoplasms during active surveillance with follow-up longer than 5 years. Urology 77:787–791

    PubMed  Google Scholar 

  56. Mindrup SR, Pierre JS, Dahmoush L, Konety BR (2005) The prevalence of renal cell carcinoma diagnosed at autopsy. BJU Int 95:31–33

    PubMed  Google Scholar 

  57. Bosniak MA (1995) Observation of small incidentally detected renal masses. Semin Urol Oncol 13:267–272

    CAS  PubMed  Google Scholar 

  58. Duffey BG, Choyke PL, Glenn G et al (2004) The relationship between renal tumor size and metastases in patients with von Hippel-Lindau disease. J Urol 172:63–65

    PubMed  Google Scholar 

  59. Ahmad AE, Finelli A, Jewett M (2016) Surveillance of small renal masses. Urology 98:8–13

    PubMed  Google Scholar 

  60. Jewett MA, Mattar K, Basiuk J et al (2011) Active surveillance of small renal masses: progression patterns of early stage kidney cancer. Eur Urol 60:39–44

    PubMed  Google Scholar 

  61. Rosales JC, Haramis G, Moreno J et al (2010) Active surveillance for renal cortical neoplasms. J Urol 183:1698–1702

    PubMed  Google Scholar 

  62. Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217–2220

    PubMed  Google Scholar 

  63. Bell ER (1938) A classification of renal tumors with observation of the frequency of the various types. J Urol 39:238–243

    Google Scholar 

  64. Remzi M, Ozsoy M, Klingler HC et al (2006) Are small renal tumors harmless? Analysis of histopathologic features according to tumors 4 cm or less in diameter. J Urol 176:896–899

    PubMed  Google Scholar 

  65. Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425–431

    PubMed  Google Scholar 

  66. Kunkle DA, Crispen PL, Li T et al (2007) Tumor size predicts synchronous metastatic renal cell carcinoma: implications for surveillance of small renal masses. J Urol 177:1692

    PubMed  Google Scholar 

  67. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK (2007) Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Cancer 109:1763–1768

    PubMed  Google Scholar 

  68. Kutikov A, Egleston BL, Canter D, Smaldone MC, Wong YN, Uzzo RG (2012) Competing risks of death in patients with localized renal cell carcinoma: a comorbidity based model. J Urol 188:2077–2083

    PubMed  PubMed Central  Google Scholar 

  69. Lughezzani G, Sun M, Budaus L, Thuret R, Perrotte P, Karakiewicz PI (2010) Population-based external validation of a competing-risks nomogram for patients with localized renal cell carcinoma. J Clin Oncol 28:e299–e300

    PubMed  Google Scholar 

  70. Klatte T, Patard J-J, de Martino M (2008) Tumor size does not predict risk of metastatic disease or prognosis of small renal cell carcinomas. J Urol 179(5):1719–1726

    PubMed  Google Scholar 

  71. Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma- a meta-analysis and review. J Urol 179:1227–1233

    PubMed  Google Scholar 

  72. Rais-Bahrami S, Guzzo TJ, Jarrett TW, Kavoussi LR, Allaf ME (2009) Incidentally discovered renal masses: oncological and perioperative outcomes in patients with delayed surgical intervention. BJU Int 103:1355–1358

    PubMed  Google Scholar 

  73. Crispen PL, Viterbo R, Fox EB, Greenberg RE, Chen DY, Uzzo RG (2008) Delayed intervention of sporadic renal masses undergoing active surveillance. Cancer 112:1051–1057

    PubMed  Google Scholar 

  74. Ambani SN, Morgan TM, Montgomery JS et al (2016) Predictors of delayed intervention for patients on active surveillance for small renal masses: does renal mass biopsy influence our decision. Urology 98:88–96

    PubMed  Google Scholar 

  75. Pierorazio PM, Johnson MH, Ball MW et al (2015) Five-year analysis of a multi-institutional prospective clinical trial of delayed intervention and surveillance for small renal masses: the DISSRM registry. Eur Urol 68:408–415

    PubMed  Google Scholar 

  76. Robson CJ, Churchill BM, Anderson W (1969) The results of radical nephrectomy for renal cell carcinoma. J Urol 101:297–301

    CAS  PubMed  Google Scholar 

  77. Huang WC, Atoria CL, Bjurlin M et al (2015) Management of small kidney cancers in the new millennium: contemporary trends and outcomes in a population-based cohort. JAMA Surgery 150:664–672

    PubMed  Google Scholar 

  78. Van Poppel H, Joniau S (2007) Is surveillance an option for the treatment of small renal masses? Eur Urol 52:1323–1330

    PubMed  Google Scholar 

  79. Thompson RH, Boorjian SA, Lohse CM et al (2008) Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 179:468–471

    PubMed  Google Scholar 

  80. Poulakis V, Witzsch U, de Vries R et al (2003) Quality of life after surgery for localized renal cell carcinoma: comparison between radical nephrectomy and nephron-sparing surgery. Urology 62:814–820

    PubMed  Google Scholar 

  81. Weight CJ, Lieser G, Larson BT et al (2010) Partial nephrectomy is associated with improved overall survival compared to radical nephrectomy in patients with unanticipated benign renal tumors. Eur Urol 58:293–298

    PubMed  Google Scholar 

  82. Huang WC, Elkin EB, Levey AS et al (2009) Partial nephrectomy versus radical nephrectomy in patients with small renal tumors—Is there a difference in mortality and cardiovascular outcomes? J Urol 181:55–61

    PubMed  Google Scholar 

  83. Lane BR, Fergany AF, Weight CJ, Campbell SC (2010) Renal functional outcomes after partial nephrectomy with extended ischemia intervals are better than after radical nephrectomy. J Urol 184:1286–1290

    PubMed  Google Scholar 

  84. Lau WK, Blute ML, Weaver AL, Torres VE, Zincke H (2000) Matched comparison of radical nephrectomy versus nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc 75:1236–1242

    CAS  PubMed  Google Scholar 

  85. McKiernan J, Simmons R, Katz J, Russo P (2002) Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology 59:816–820

    PubMed  Google Scholar 

  86. Van Poppel H, Da Pozzo L, Albrecht W et al (2011) A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 59:543–552

    PubMed  Google Scholar 

  87. Scosyrev E, Messing EM, Sylvester R et al (2014) Renal function after nephron-sparing surgery versus radical nephrectomy: results from EORTC randomized trial 30904. Eur Urol 65:372–377

    PubMed  Google Scholar 

  88. Leone AR, Diorio GJ, Spiess PE, Gilbert SM (2016) Contemporary issues surrounding small renal masses: evaluation, diagnostic biopsy, nephron sparing, and novel treatment modalities. Oncology 30:507–514

    PubMed  Google Scholar 

  89. Thompson RH, Lane BR, Lohse CM et al (2012) Renal function after partial nephrectomy: effect of warm ischemia relative to quantity and quality of preserved kidney. Urology 79:356–360

    PubMed  Google Scholar 

  90. Aron M, Gill IS, Campbell SC (2012) A nonischemic approach to partial nephrectomy is optimal. J Urol 187:387–390

    PubMed  Google Scholar 

  91. Simmons MN, Fergany AF, Campbell SC (2011) Effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol 186:405–410

    PubMed  Google Scholar 

  92. Yossepowitch O, Eggener SE, Serio A et al (2006) Temporary renal ischemia during nephron sparing surgery is associated with short- term but not long-term impairment in renal function. J Urol 176:1339–1343

    PubMed  Google Scholar 

  93. Mir MC, Campbell RA, Sharma N et al (2013) Parenchymal volume preservation and ischemia during partial nephrectomy: functional and volumetric analysis. Urology 82:263–268

    PubMed  Google Scholar 

  94. Castaneda CV, Danzig MR, Finkelstein JB et al (2015) The natural history of renal functional decline in patients undergoing surveillance in the DISSRM registry. Urol Oncol 33:166.e17–e20

    Google Scholar 

  95. Ng CK, Gill IS, Patil MB et al (2012) Anatomic renal artery branch microdissection to facilitate zero-ischemia partial nephrectomy. Eur Urol 61:67–74

    PubMed  Google Scholar 

  96. Weight CJ, Thompson RH (2012) The role of ischemia, or the lack thereof, during partial nephrectomy. Eur Urol 61:75–76

    PubMed  Google Scholar 

  97. Simmons MN, Hillier SP, Lee BH, Fergany AF, Kaouk J, Campbell SC (2012) Functional recovery after partial nephrectomy: effects of volume loss and ischemic injury. J Urol 187:1667–1673

    PubMed  Google Scholar 

  98. Liss MA, Wang S, Palazzi K et al (2014) Evaluation of national trends in the utilization of partial nephrectomy in relation to the publication of the American Urologic Association guidelines for the management of clinical T1 renal masses. BMC Urol 14:101

    PubMed  PubMed Central  Google Scholar 

  99. Lane BR, Campbell SC, Gill IS (2013) 10-year oncologic outcomes after laparoscopic and open partial nephrectomy. J Urol 190:44–49

    PubMed  Google Scholar 

  100. Gill IS, Kamoi K, Aron M, Desai MM (2010) 800 laparoscopic partial nephrectomies: a single surgeon series. J Urol 183:34–41

    PubMed  Google Scholar 

  101. Novara G, La Falce S, Kungulli A, Gandaglia V, Ficarra V, Mottrie A (2016) Robot-assisted partial nephrectomy. Int J Surg 36:554–559

    PubMed  Google Scholar 

  102. Ficarra V, Bhayani S, Porter J et al (2012) Predictors of warm ischemia time and perioperative complications in a multicenter, international series of robot-assisted partial nephrectomy. Eur Urol Suppl 11:E35–U358

    Google Scholar 

  103. Spana G, Haber GP, Dulabon LM et al (2011) Complications after robotic partial nephrectomy at centers of excellence: multi-institutional analysis of 450 cases. J Urol 186:417–421

    PubMed  Google Scholar 

  104. Kasivisvanathan V, Raison N, Challacombe B (2016) The diagnosis and management of small renal masses. Int J Surg 36:493–494

    PubMed  Google Scholar 

  105. Thompson RH (2014) Partial versus radical nephrectomy: the debate regarding renal function ends while the survival controversy continues. Eur Urol 65:378–379

    PubMed  Google Scholar 

  106. Lane BR, Demirjian S, Derweesh IH et al (2015) Survival and functional stability in chronic kidney disease due to surgical removal of nephrons: importance of the new baseline glomerular filtration rate. Eur Urol 68:996–1003

    PubMed  Google Scholar 

  107. Lane BR, Golan S, Eggener S et al (2013) Differential use of partial nephrectomy for intermediate and high complexity tumors may explain variability in reported utilization rates. J Urol 189:2047–2053

    PubMed  Google Scholar 

  108. Zargar H, Allaf ME, Bhayani S et al (2015) Trifecta and optimal perioperative outcomes of robotic and laparoscopic partial nephrectomy in surgical treatment of small renal masses: a multi-institutional study. BJU Int 116:407–414

    PubMed  Google Scholar 

  109. Zargar H, Atwell TD, Cadeddu JA et al (2016) Cryoablation for small renal masses: selection criteria, complications, and functional and oncologic results. Eur Urol 69:116–128

    PubMed  Google Scholar 

  110. Gunn AJ, Gervais DA (2014) Percutaneous ablation of the small renal mass- techniques and outcomes. Semin Interv Radiol 31:33–41

    Google Scholar 

  111. Higgins LJ, Hong K (2015) Renal ablation techniques: state of the art. AJR Am J Roentgenol 205:735–741

    PubMed  Google Scholar 

  112. Gervais DA, McGovern FJ, Arellano RS et al (2005) Radiofrequency ablation of renal cell carcinoma: Part 1, indications, results, and role in patient management over a 6-year period and ablation of 100 tumors. AJR Am J Roentgenol 185:64–71

    PubMed  Google Scholar 

  113. Breen DJ, Rutherford EE, Stedman B et al (2007) Management of renal tumors by image-guided radiofrequency ablation: experience in 105 tumors. Cardiovasc Interv Radiol 30:936–942

    Google Scholar 

  114. Miller AJ, Kurup AN, Schmit GD et al (2015) Percutaneous clinical T1a renal mass ablation in the octogenarian and nonagenarian: oncologic outcomes and morbidity. J Endourol 29:671–676

    PubMed  Google Scholar 

  115. Whitson JM, Harris CR, Meng MV (2012) Population-based comparative effectiveness of nephron-sparing surgery versus ablation for small renal masses. BJU Int 110:1438–1443

    PubMed  Google Scholar 

  116. Thompson RH, Atwell T, Schmit G et al (2015) Comparison of partial nephrectomy and percutaneous ablation for cT1 renal masses. Eur Urol 67(2):252–259

    PubMed  Google Scholar 

  117. Katsanos K, Mailli L, Krokidis M et al (2014) Systematic review and meta-analysis of thermal ablation versus surgical nephrectomy for small renal tumors. Cardiovasc Interv Radiol 37:427–437

    CAS  Google Scholar 

  118. Narayanan G, Doshi MH (2016) Irreversible electroporation (IRE) in renal tumors. Curr Urol Rep 17:15

    PubMed  Google Scholar 

  119. Khan F, Sriprasad S, Keeley FX (2012) Cryosurgical ablation for small renal masses, current status and future prospects. Brit J Med Surg Urol 5:S28–S34

    Google Scholar 

  120. Christinat Y, Krek W (2015) Integrated genomic analysis identifies subclasses and prognosis signatures of kidney cancer. Oncotarget 6:10521–10531

    PubMed  PubMed Central  Google Scholar 

  121. The Cancer Genome Atlas Research Network (2013) Comprehensive molecular characterization of clear cell renal cell carcinoma. Nature 499:43–49

    PubMed Central  Google Scholar 

  122. The Cancer Genome Atlas Research Network (2016) Comprehensive molecular characterization of papillary renal-cell carcinoma. NEJM 374:135–145

    Google Scholar 

  123. Iliev R, Stanik M, Fedorko M et al (2016) Decreased expression levels of PIWIL1, PIWIL2, and PIWIL4 are associated with worse survival in renal cell carcinoma patients. Onco Targets Ther 9:217–222

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Russo P, Huang W (2008) The medical and oncological rationale for partial nephrectomy for the treatment of T1 renal cortical tumors. Urol Clin N Am 35:635–643

    Google Scholar 

  125. Morrissey JJ, Mobley J, Figenshau RS, Vetter J, Bhayani S, Kharasch ED (2015) Urine aquaporin 1 and perilipin 2 differentiate renal carcinomas from other imaged renal masses and bladder and prostate cancer. Mayo Clin Proc 90:35–42

    CAS  PubMed  PubMed Central  Google Scholar 

  126. Tondel C, Vikse BE, Bostad L, Svarstad E (2012) Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988–2010. Clin J Am Soc Nephrol 7:1591–1597

    PubMed  PubMed Central  Google Scholar 

  127. Morrissey JJ, Mellnick VM, Luo J et al (2015) Evaluation of urine aquaporin-1 and perilipin-2 concentrations as biomarkers to screen for renal cell carcinoma: a prospective cohort study. JAMA Oncol 1:204–212

    PubMed  PubMed Central  Google Scholar 

  128. Tobis S, Knopf JK, Silvers CR et al (2012) Near infrared fluorescence imaging after intravenous indocyanine green: initial clinical experience with open partial nephrectomy for renal cortical tumors. Urology 79:958–964

    PubMed  Google Scholar 

  129. Manny TB, Krane LS, Hemal AK (2013) Indocyanine green cannot predict malignancy in partial nephrectomy: histopathologic correlation with fluorescence pattern in 100 patients. J Endourol Endourol Soc 27:918–921

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Urology and Urologic Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd, MOB L002H, Duarte, CA, 91010, USA

    Avinash Chenam & Clayton Lau

Authors
  1. Avinash Chenam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clayton Lau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Clayton Lau .

Editor information

Editors and Affiliations

  1. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA

    Siamak Daneshmand

  2. City of Hope National Medical Center, Duarte, CA, USA

    Kevin G. Chan

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chenam, A., Lau, C. (2018). Management of Small Renal Masses. In: Daneshmand, S., Chan, K. (eds) Genitourinary Cancers . Cancer Treatment and Research, vol 175. Springer, Cham. https://doi.org/10.1007/978-3-319-93339-9_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-93339-9_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93338-2

  • Online ISBN: 978-3-319-93339-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation