Metastatic potential of the small renal mass: why can't we agree?

摘要

The vast majority of renal masses are now diagnosed at a low clinical stage and present patients and clinicians with the daunting challenge of multiple treatment options. This is especially true in the elderly and in medically complex patients, patients who prefer to avoid potentially morbid surgical treatment. Small renal masses (SRMs) can be approached with nephron-sparing surgery, radical nephrec-tomy, tumor ablation, or active surveillance depending on tumor features, patient characteristics, and patient preferences. To clarify the most appropriate treatment options and recommendations, patients and providers must weigh the patient's projected longevity, the threat posed by the cancer to shorten this longevity, the effectiveness of available treatments, and the associated morbidity of the treatment choices. For an accurate discussion with our patients, it is vital that we correctly understand the threat of SRMs.