Renal Cancer pp 133-157 | Cite as

Natural History, Role of Biopsy, and Active Surveillance of Renal Masses

  • Benjamin T. Ristau
  • Anthony Corcoran
  • Marc C. Smaldone
  • Robert G. Uzzo
  • David Y. T. ChenEmail author


With increased utilization of cross-sectional imaging over the past few decades, we have observed a rise in asymptomatic, clinically localized, small renal masses (SRMs). Despite increased detection and treatment, mortality rates from kidney cancer remain relatively unchanged. This suggests that a proportion of small renal masses are indolent tumors that may not require surgical intervention. From these observations, active surveillance (AS) has emerged as an alternative management strategy in appropriately selected patients. Furthermore, the use of AS has provided the basis for describing the natural history of renal masses managed without intervention. As data from prospective registries continue to mature, we have observed that many incidental renal masses demonstrate slow growth kinetics with a low rate of progression to metastatic disease. Therefore, the use of AS appears to be a safe initial management option in patients with SRMs.


Renal cell carcinoma Natural history Percutaneous biopsy Active surveillance Growth kinetics 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Benjamin T. Ristau
    • 1
  • Anthony Corcoran
    • 2
  • Marc C. Smaldone
    • 3
  • Robert G. Uzzo
    • 3
  • David Y. T. Chen
    • 3
    Email author
  1. 1.Department of Surgery/Division of UrologyUConn HealthFarmingtonUSA
  2. 2.Department of UrologyNYU Winthrop HospitalGarden CityUSA
  3. 3.Department of Surgical Oncology, Division of UrologyFox Chase Cancer Center – Temple University Health SystemPhiladelphiaUSA

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