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Current view on small renal masses


Authors: A. Čermák;  D. Pacík;  V. Vít
Published in: Urol List 2012; 10(3): 6-15

Overview

Renal cancers and their treatment represent a significant subfield of uro-oncology. Every single urologist, be it outpatient specialist or clinician, will deal with this condition during his/her practice. A large proportion of diagnostic and therapeutic approaches and monitoring methods are based on imaging. Radiological imaging methods are being continuously improved. Better availability of radiological imaging techniques has resulted in higher rate of small renal masses detection. These tumours are asymptomatic and usually detected incidentally during testing for different indication. Surgery is the standard treatment modality. Alternative options include less invasive approaches (ablation therapy); and conservative treatment is feasible in selected patient population with shorter estimated survival. The authors review current techniques for SRM treatment, their indications and outcomes. Furthermore they discuss the options and principles of active surveillance.

Key words:
small renal masses, ablation therapy, radiofrequency ablation, cryoablation, renal cancer biopsy, active surveillance


Sources

1. Geryk E. Srovnání výskytu zhoubných novotvarů: Č̌eská republika a vybrané státy = Comparison of cancer incidence: Czech Republic and selected countries. Praha: Galén 2004.

2. Sobotka R, Hanuš T. Nádory ledvin. Postgraduální medicína 2001; 1: 48.

3. Morávek P, Morávek P Jr., Dvořák P et al. Perku­tánní radiofrekvenční ablace (RFA) v léčbě nádorů ledvin – vlastní zkušenosti. Ces Urol 2010; 14(2): 104–109.

4. Jemal A, Siegel R, Xu J et al. Cancer statistics, 2010. CA Cancer J Clin 2010; 60(5): 277–300.

5. Mathew A, Devesa SS, Fraumeni JF Jr. et al. Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev 2002; 11(2): 171–178.

6. Kane CJ, Mallin K, Ritchey J et al. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer 2008; 113(1): 78–83.

7. Gill IS, Aron M, Gervais DA et al. Clinical practice. Small renal mass. N Engl J Med 2010; 362(7): 624–634.

8. Nguyen MM, GillI S. Effect of renal cancer size on the prevalence of metastasis at diagnosis and mortality. J Urol 2009; 181(3): 1020–1027.

9. Frank I, Blute ML, Cheville JC et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 2003; 170(6 Pt 1) : 2217–2220.

10. Uzzo RG, Novick AC. Nephron sparing surgery for renal tumors: indications, techniques and outcomes. J Urol 2001; 166(1): 6–18.

11. VanPoppel H, DaPozzo L, Albrecht W et al. 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 2011; 59(4): 543–552.

12. Patard JJ, Shvarts O, Lam JS et al. Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multi-center experience. J Urol 2004; 171(6 Pt 1): 2181–2185.

13. Go AS, Chertow GM, Fan D et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospi- talization. N Engl J Med 2004; 351(13): 1296–1305.

14. Miller DC, Schonlau M, Litwin MS et al. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer 2008; 112(3): 511–520.

15. Huang WC, Elkin EB, Levey AS et al. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors – is there a difference in mortality and cardiovascular outcomes? J Urol 2009; 181(1): 55–61.

16. Weight CJ, Lieser G, Larson BT et al. Partial nephrectomy is associated with improved overall survival compared to radical nephrectomy in patients with unanticipated benign renal tumours. Eur Urol 2010; 58(2): 293–298.

17. Ljungberg B, Cowan NC, Hanbury DC et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol 2010; 58(3): 398–406.

18. Campbell SC, Novick AC, Belldegrun A et al. Guide­line for management of the clinical T1 renal mass. J Urol 2009; 182(4): 1271–1279.

19. Dulabon LM, Lowrance WT, Russo P et al. Trends in renal tumor surgery delivery within the United States. Cancer 2010; 116(10): 2316–2321.

20. Van Poppel H, Da Pozzo L, Albrecht W et al. A prospective randomized EORTC intergroup phase 3 study comparing the complications of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 2007; 51(6): 1606–1615.

21. Bruner B, Breau RH, Lohse CM et al. Renal nephro­metry score is associated with urine leak after partial nephrectomy. BJU Int 2011; 108(1): 67–72.

22. Thompson RH, Frank I, Lohse CM et al. The impact of ischemia time during open nephron sparing surgery on solitary kidneys: a multi-institutional study. J Urol 2007; 177(2): 471–476.

23. Carini M, Minervini A, Masieri L et al. Simple enucleation for the treatment of PT1a renal cell carcinoma: our 20-year experience. Eur Urol 2006; 50(6): 1263–1271.

24. Bensalah K, Pantuck AJ, Rioux-Leclercq N et al. Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery. Eur Urol 2010; 57(3): 466–473.

25. Ng CS, Gill IS, Ramani AP et al. Transperitoneal versus retroperi- toneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol 2005; 174(3): 846–849.

26. Becker F, Siemer S, Humke U et al. Elective nephron sparing surgery should become standard treat- ment for small unilateral renal cell carcinoma: long-term survival data of 216 patients. Eur Urol 2006; 49(2): 308–313.

27. Patard J-J, Pantuck AJ, Crepel M et al. Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. Eur Urol 2007; 52(1): 148–154.

28. Gill IS, Kavoussi LR, Lane BR et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol 2007; 178(1): 41–46.

29. Permpongkosol S, Bagga HS, Romero FR et al. Laparoscopic versus open partial nephrectomy for the treatment of pathological T1N0M0 renal cell carci­noma: a 5-year survival rate. J Urol 2006; 176(5): 1984–1988.

30. Lane BR, Gill IS. 7-year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol 2010; 183(2): 473–479.

31. Simmons MN, Gill IS. Decreased complications of contemporary laparoscopic partial nephrectomy: use of a standardized reporting system. J Urol 2007; 177(6): 2067–2073.

32. Gill IS, Kamoi K, Aron M et al. 800 Laparoscopic partial nephrectomies: a single surgeon series. J Urol 2010; 183(1): 34–41.

33. Gill IS, Eisenberg MS, Aron M et al. “Zero ischemia” partial nephrectomy: novel laparoscopic and robotic technique. Eur Urol 2011; 59(1): 128–134.

34. Rogers C, Sukumar S, Gill IS. Robotic partial nephrec­tomy: the real benefit. Curr Opin Urol 2011; 21(1): 60–64.

35. Ficarra V, Novara G, Mottrie A et al. AUA Update series 2010.

36. Desai PJ, Andrews PE, Ferrigni RG et al. Laparo­scopic partial nephrectomy at the Mayo Clinic Arizona: follow-up surveillance of positive margin disease. Urology 2008; 71(2): 283–286.

37. Mir SA, Cadeddu JA, Sleeper JP et al. Cost comparison of robotic, laparoscopic, and open partial nephrectomy. J Endourol 2011; 25(3): 447–453.

38. Wisenbaugh ES, Cheney SM, Martin GL et al. Minimálně invazivní laparoskopická a roboticky asistovaná parciální resekce ledviny: stručná historie a přehled. Urol List 2011; 9(4): 17–21.

39. Hora M, Hes O, Klečka J. Miniinvazivní ledvinu šetřící ablační metodiky v léčbě nádorů ledvin. Urol List 2003; 1(1): 26–29.

40. Čermák A, Pacík D. Radiofrekvenční ablace nádorů ledvin: Urol List 2012; 10(1): 31–35.

41. Čermák A, Pacík D. Minimálně invazivní, ablační techniky při léčbě malých renálních tumorů. Urol List 2012; 10(3): Epub ahead of print.

42. Ogan K, Jacomides L, Dolmatch BL et al. Percu­ta­neous radio fre- quency ablation of renal tumors: technique, limitations, and morbidity. Urology 2002; 60(6): 954–958.

43. Weight CJ, Kaouk JH, Hegarty NJ et al. Correlation of radiographic imaging and histopathology following cryoablation and radio frequency ablation for renal tumors. J Urol 2008; 179(4): 1277–1281.

44. Kunkle DA, Egleston BL, Uzzo RG. Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol 2008; 179(4): 1227–1233.

45. Volpe A, Jewett MA. The role of surveillance for small renal masses. Nat Clin Pract Urol 2007; 4(1): 2–3.

46. Hollingsworth JM, Miller DC, Daignault S et al. Five-year survival after surgical treatment for kidney cancer: a population- based competing risk analysis. Cancer 2007; 109(9): 1763–1768.

47. Smaldone MC, Kutikov A, Canter DJ et al. A Critical Analysis of Active Surveillance with Delayed Curative Intent for the Treatment of Small Renal Masses. Podium presentation (#11); presented at the Society of Urologic Oncology 2010.

48. Smaldone MC, Canter D, Simhan J et al. Aktivní sledování malých tumorů ledviny. Urol List 2012; 10(1): 26–30.

49. Jewett MAS, Mattar K, Basiuk J et al. Active surveillance of small renal masses: progression patterns of early stage kidney cancer. Eur Urol 2011; 60(1): 39–44.

50. Gill IS, Aron M, Gervais DA et al. Clinical practice. Small renal mass. N Engl J Med 2010; 362(7): 624–634.

51. Volpe A, Kachura JR, Geddie WR et al. Techni­ques, safety and accuracy of sampling of renal tumors by fine needle aspiration and core biopsy. J Urol 2007; 178(2): 379–386.

52. Lechevallier E, Andre M, Barriol D et al. Fine-needle percutaneous biopsy of renal masses with helical CT guidance. Radiology 2000; 216(2): 506–510.

53. Neuzillet Y, Lechevallier E, Andre M et al. Accuracy and clinical role of fine needle percutaneous biopsy with computerized tomography guidance of small (less than 4.0 cm) renal masses. J Urol 2004; 171(5): 1802–1805.

54. Vasudevan A, Davies RJ, Shannon BA et al. Inci­den­tal renal tumours: the frequency of benign lesions and the role of preoperative core biopsy. BJU Int 2006; 97(5): 946–949.

55. Schmidbauer J, Remzi M, Memarsadeghi M et al. Diagnostic accuracy of computed tomography-guided percutaneous biopsy of renal masses. Eur Urol 2008; 53(5): 1003–1012.

56. Lebret T, Poulain JE, Molinie V et al. Percuta-neous core biopsy for renal masses: indications, accuracy and results. J Urol 2007; 178(4 Pt 1): 1184–1188.

57. Maturen KE, Nghiem HV, Caoili EM et al. Renal mass core biopsy: accuracy and impact on clinical management. AJR Am J Roentgenol 2007; 188(2): 563–570.

58. Volpe A, Mattar K, Finelli A et al. Contemporary results of percutaneous biopsy of 100 small renal masses: a single center experience. J Urol 2008; 180(6): 2333–2337.

59. Blumenfeld AJ, Guru K, Fuchs GJ et al. Percu­ta­neous biopsy of renal cell carcinoma underestimates nuclear grade. Urology 2010; 76(3): 610–613.

60. Wang R, Wolf JS Jr., Wood DP Jr. et al. Accuracy of percutaneous core biopsy in management of small renal masses. Urology 2009; 73(3): 586–590.

61. Veltri A, Garetto I, Tosetti I et al. Diagnostic accuracy and clinical impact of imaging-guided needle biopsy of renal masses. Retrospective analysis on 150 cases. Eur Radiol 2011; 21(2): 393–401.

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