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World Journal of Urology

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01-06-2010 | Topic Paper

Management of small renal masses: a review

Authors: Mesut Remzi, Elchin Javadli, Mehmet Özsoy

Published in: World Journal of Urology | Issue 3/2010

Abstract

Introduction

Recently, small renal masses (SRMs) (≤4 cm) are found more frequently, especially in the elderly and co-morbid patients. Standard treatment for SRMs is nephron-sparing surgery (NSS). New techniques like energy ablation and surveillance have been introduced.

Materials and methods

Overview of treatment options for SRMs, based mainly on the meta-analyses available for NSS, cryoablation, radio-frequency ablation (RFA), and surveillance.

Results

NSS for SRMs is the standard therapy with excellent cancer-specific survival rates up to 97%. Cryoablation was mainly performed laparoscopically, and RFA mainly percutaneously. Pretreatment biopsies were used frequently for cryoablation (80%) and less frequently for RFA (50%). Primary failure rate for cryoablation was 4.8% and for RFA 13%. Major complication rates for both procedures are around 5%. Based on 6-month post-ablative biopsies, non-contrast enhancement seems to be an effective surrogate marker after cryoablation, but not after RFA. Follow-up after energy ablation is too short to draw final conclusion. Data on surveillance are based on small, retrospective data with insufficient follow-up. Growth patterns during follow-up do not correlate with the underlying tumour entity.

Conclusion

Standard therapy for SRMs is still NSS. Energy ablation should be reserved for the elderly patients with co-morbidities and surveillance for the elderly and infirm patients.

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Title: Management of small renal masses: a review
Authors: Mesut Remzi
Elchin Javadli
Mehmet Özsoy
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 3/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-010-0516-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management of small renal masses: a review

Abstract

Introduction

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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