Renal Cell Carcinoma pp 167-194

Part of the Current Clinical Urology book series (CCU)

Active Surveillance of the Small Renal Mass

  • Marc C. Smaldone
  • Daniel Canter
  • Alexander Kutikov
  • Robert G. Uzzo


Increased abdominal imaging has led to the significant incidental detection of clinically localized renal tumors. While the gold standard remains surgical excision, no demonstrable improvement in cancer-specific mortality has been observed, implying that a proportion of small renal masses (SRMs) may be indolent tumors that do not require surgical intervention. As a result, active surveillance (AS) has emerged as an alternative management strategy in select elderly or comorbid patients with significant competing risks. Although the contemporary literature characterizing the natural history of untreated renal tumors is limited, recent data demonstrate that the majority of SRMs demonstrate slow growth kinetics with low rates of metastatic progression while under observation. Prospective trials are necessary to define entry and intervention criteria for contemporary AS protocols.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Marc C. Smaldone
    • 1
    • 2
  • Daniel Canter
    • 2
  • Alexander Kutikov
    • 2
  • Robert G. Uzzo
    • 2
  1. 1.Merion StationUSA
  2. 2.Division of Urologic Oncology, Department of Surgical OncologyFox Chase Cancer CenterPhiladelphiaUSA

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