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Treatment of Small Renal Masses

Urologic Oncology

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Abstract

The incidence of renal cell carcinoma has been rising for years, particularly in industrial countries. It is very frequently diagnosed at the early stage of T1a, probably due to better early detection. At the same time, there is an increasing prevalence of chronic renal failure with higher morbidity and shorter life expectancy in those affected. Both factors underscore the urgent need for nephron-sparing treatments. The gold standard has thus shifted from radical to partial nephrectomy. Given good conditions, the intervention can be performed by laparoscopy, which offers the advantages of lower invasiveness. A treatment alternative can be advantageous for selected patients with high morbidity and an increased risk of anesthetic or surgical complications. Appropriate risk stratification requires prior histological confirmation of the small renal mass (cT1a) by assessment of biopsy specimens. Active surveillance represents a controlled delay in the initiation of treatment. Percutaneous radiofrequency ablation (RFA) and laparoscopic cryoablation are currently the most common treatment alternatives, though there are limitations particularly for central tumors near the renal hilum. Newer ablation procedures such as high-intensity focused ultrasound (HIFU), irreversible electroporation, microwave ablation, percutaneous stereotactic ablative radiotherapy, and high-dose brachytherapy have high potential in some cases but are still considered experimental for the treatment of renal cell carcinoma.

M. Schostak and J.J. Wendler contributed equally to this work.

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    Authors and Affiliations

    1. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., University Hospital of Magdeburg, Leipziger Straße 44, D - 39120, Magdeburg, Deutschland

      M. Schostak, J. J. Wendler & U. B. Liehr

    2. Universitätsklinik für Urologie und Kinderurologie, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany

      M. Schostak, J. J. Wendler & U. B. Liehr

    3. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Urologische Praxis Drs. A & B Baumunk, Backnang, Germany

      D. Baumunk

    4. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Klinik für Urologie und Kinderurologie, Klinikum Fürth, Fürth, Germany

      A. Blana

    5. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Asklepios Stadtklinik Bad Tölz, Urologische Klinik, Schützen str. 15, Bad Tölz, 83646, Germany

      R. Ganzer

    6. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Jena, Jena, Germany

      T. Franiel

    7. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Urologische Klinik und Poliklinik, Universitaetsklinikum Essen, Heidelberg, Germany

      B. Hadaschik

    8. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Urologische Praxis Dr. Henkel & Dr. Kahmann, Berlin, Germany

      T. Henkel

    9. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Klinik für Urologie, Theresienkrankenhaus Mannheim, Mannheim, Germany

      K. U. Köhrmann

    10. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Institut für Pathologie, Sana Klinikum Offenbach, Offenbach am Main, Germany

      J. Köllermann

    11. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Urologie am Ebertplatz, Köln, Germany

      T. Kuru

    12. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Klinik für Urologie, Marien-Krankenhaus gGmbH, Bergisch-Gladbach, Germany

      S. Machtens

    13. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Klinik für Urologie, Augusta-Kranken-Anstalt gGmbH, Bochum, Germany

      A. Roosen

    14. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Martini-Klinik am UKE GmbH, Hamburg, Deutschland

      G. Salomon

    15. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Abteilung für Radiologie, Deutschen Krebsforschungszentrums Heidelberg, Heidelberg, Germany

      H. P. Schlemmer

    16. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V., Urologische Gemeinschaftspraxis, Sinsheim, Baden-Württemberg, Germany

      L. Sentker

    17. Arbeitskreis für fokale und Mikrotherapie der Akademie (AKFM) der Deutschen Gesellschaft für Urologie (DGU) e.V. Klinik für Urologie und Kinderurologie, Krankenhaus Nordwest, Frankfurt/Main, Germany

      U. Witzsch

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    Editors and Affiliations

    1. Dept. of Urology & Urologic Oncology, Hannover Medical School, Hannover, Germany

      Axel S. Merseburger

    2. Dept. of Urology, University of Regensburg St. Josef Medical Centre, Regensburg, Germany

      Maximilian Burger

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    1. Klinik für Urologie, Ratzeburger Allee 160, 23538, Lübeck, Germany

      Mario W. Kramer

    2. Department of Urology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany

      Axel S. Merseburger

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    Schostak, M. et al. (2017). Treatment of Small Renal Masses. In: Merseburger, A., Burger, M. (eds) Urologic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-42603-7_61-1

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    • DOI: https://doi.org/10.1007/978-3-319-42603-7_61-1

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    1. Latest

      Treatment of Small Renal Masses
      Published:
      18 January 2018

      DOI: https://doi.org/10.1007/978-3-319-42603-7_61-2

    2. Original

      Treatment of Small Renal Masses
      Published:
      29 September 2017

      DOI: https://doi.org/10.1007/978-3-319-42603-7_61-1

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