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Update on active surveillance for clinical T1 renal tumors

Joice, Gregory A.; Pierorazio, Phillip M.; Allaf, Mohamad E.

doi: 10.1097/MOU.0000000000000311
NEW INSIGHTS IN DIAGNOSIS AND MANAGEMENT OF RENAL CELL CARCINOMA: Edited by Jose Karam and Tobias Klatte
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Purpose of review The purpose is to discuss current data on the utilization and outcomes of active surveillance for T1a renal masses. Specifically, to address which patients are optimal for active surveillance and how their outcomes differ from those undergoing immediate treatment.

Recent findings Although nephron sparing surgery is the standard of care for small renal masses (SRMs), active surveillance is becoming a more popular intervention given the results of prospective studies revealing active surveillance to be safe and have excellent cancer-specific survival with intermediate follow-up. Older and sicker patients have competing risk of death from other causes when diagnosed with a SRM.

Summary Active surveillance is becoming a more popular treatment modality for SRMs given the increasing number of incidental diagnoses and better understanding of their often indolent course. Active surveillance with delayed intervention is a well-tolerated treatment modality and appears to have the most benefit for those patients that are older with more comorbidities.

Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Correspondence to Gregory A. Joice, MD, The James Buchanan Brady Urological Institute, 1800 Orleans Street, Park 217, Baltimore, MD 21287, USA. E-mail: gjoice1@jhmi.edu

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