Comparative Effectiveness of Surgical Treatments for Small Renal Masses

Shree Agrawal; Hillary Sedlacek; Simon P Kim

doi:10.1016/j.ucl.2016.12.011

Comparative Effectiveness of Surgical Treatments for Small Renal Masses

Urol Clin North Am. 2017 May;44(2):257-267. doi: 10.1016/j.ucl.2016.12.011.

Authors

Shree Agrawal¹, Hillary Sedlacek¹, Simon P Kim²

Affiliations

¹ Department of Urology, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
² Department of Urology, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA; Center of Health Outcomes and Quality, Urology Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA; Seidman Cancer Center, Cleveland, OH, USA; Cancer Outcomes and Public Policy Effectiveness Research (COPPER) Center, Yale University, New Haven, CT, USA. Electronic address: simkim@me.com.

PMID: 28411917
DOI: 10.1016/j.ucl.2016.12.011

Abstract

In the management of small renal masses (SRMs), treatment options include partial nephrectomy (PN), radical nephrectomy (RN), ablation, renal biopsy, and active surveillance. Large series retrospective and meta-analyses demonstrate PN may confer greater preservation of renal function, overall survival, and equivalent cancer control when compared with RN. As newer therapies emerge, we should critically evaluate the risks and benefits associated with the surgical management of SRMs among patients with competing comorbidities, complex tumors, and high-risk disease. Among younger patients with SRMs amenable to resection, optimization of postoperative patient health should be prioritized.

Keywords: Localized renal tumors; Nephrectomy; Small renal masses; Surgery.

Publication types

Comparative Study
Review

MeSH terms

Clinical Decision-Making
Humans
Kidney Neoplasms / pathology
Kidney Neoplasms / surgery*
Nephrectomy* / methods
Treatment Outcome
Tumor Burden