Abstract
Surveillance for small renal masses is a growing choice of management amongst physicians and patients. These decisions, however, can be difficult as patient factors and tumor factors may blur the line between continued surveillance and intervention. Currently, there are no biomarkers that are readily available to aid in the decision making for patients with known renal cell carcinoma; however, many show promise. We herein review the literature of the adjunct tools that are currently available for decision making in small renal masses, but also new potential biomarkers that can potentially be of use.
Similar content being viewed by others
References
Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70:7–30
Patel HD, Gupta M, Joice GA, Srivastava A, Alam R, Allaf ME, Pierorazio PM (2019) Clinical stage migration and survival for renal cell carcinoma in the United States. Eur Urol Oncol 2:343–348
Barrisford GW, Singer EA, Rosner IL, Linehan WM, Bratslavsky G (2011) Familial renal cancer: molecular genetics and surgical management. Int J Surg Oncol 2011:658767
Motzer RJ, Jonasch E, Michaelson MD et al (2019) NCCN guidelines insights: kidney cancer, version 2.2020. J Natl Compr Canc Netw 17:1278–1285
Campbell S, Uzzo RG, Allaf ME et al (2017) Renal mass and localized renal cancer: AUA guideline. J Urol 198:520–529
Modi PK, Farber NJ, Singer EA (2016) Precision oncology: identifying predictive biomarkers for the treatment of metastatic renal cell carcinoma. Transl Cancer Res 5:S76–S80
Clark DJ, Dhanasekaran SM, Petralia F et al (2019) Integrated proteogenomic characterization of clear cell renal cell carcinoma. Cell 179:964-983.e31
Fisher R, Larkin J, Swanton C (2012) Inter and intratumour heterogeneity: a barrier to individualized medical therapy in renal cell carcinoma? Front Oncol 2:49
Pierorazio PM, Hyams ES, Mullins JK, Allaf ME (2012) Active surveillance for small renal masses. Rev Urol 14:13–19
Ray S, Cheaib JG, Pierorazio PM (2020) Active surveillance for small renal masses. Rev Urol 22:9–16
Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217–2220
Bhindi B, Thompson RH, Lohse CM et al (2018) The probability of aggressive versus indolent histology based on renal tumor size: implications for surveillance and treatment. Eur Urol 74:489–497
Patel HD, Semerjian A, Gupta M, Pavlovich CP, Johnson MH, Gorin MA, Allaf ME, Pierorazio PM (2019) Surgical removal of renal tumors with low metastatic potential based on clinical radiographic size: a systematic review of the literature. Urol Oncol 37:519–524
Kato M, Suzuki T, Suzuki Y, Terasawa Y, Sasano H, Arai Y (2004) Natural history of small renal cell carcinoma: evaluation of growth rate, histological grade, cell proliferation and apoptosis. J Urol 172:863–866
Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DYT, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425–431
Kunkle DA, Egleston BL, Uzzo RG (2008) Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol 179:1224–1227
McIntosh AG, Ristau BT, Ruth K et al (2018) Active surveillance for localized renal masses: tumor growth, delayed intervention rates, and >5-yr clinical outcomes. Eur Urol 74:157–164
Gupta M, Alam R, Patel HD et al (2019) Use of delayed intervention for small renal masses initially managed with active surveillance. Urol Oncol 37:18–25
Campbell SP, Tzortzakakis A, Javadi MS, Karlsson M, Solnes LB, Axelsson R, Allaf ME, Gorin MA, Rowe SP (2018) (99m)Tc-sestamibi SPECT/CT for the characterization of renal masses: a pictorial guide. Br J Radiol 91:20170526
Levey AS, Eckardt K-U, Tsukamoto Y, Levin A, Coresh J, Rossert J, De Zeeuw D, Hostetter TH, Lameire N, Eknoyan G (2005) Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 67:2089–2100
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470
Pinkham CA, Krause KJ (2009) Liver function tests and mortality in a cohort of life insurance applicants. J Insur Med 41:170–177
Seaman E, Goluboff ET, Ross S, Sawczuk IS (1996) Association of radionuclide bone scan and serum alkaline phosphatase in patients with metastatic renal cell carcinoma. Urology 48:692–695
Patel SH, Meagher MF, Saito K et al (2019) Association of elevated C-reactive protein with oncologic outcomes in renal CELL carcinoma: a multicenter analysis. J Clin Oncol 37:596
Hu Q, Gou Y, Sun C, Ding W, Xu K, Gu B, Xia G, Ding Q (2014) The prognostic value of C-reactive protein in renal cell carcinoma: a systematic review and meta-analysis. Urol Oncol 32:50.e1–8
Fischer K, Theil G, Hoda R, Fornara P (2012) Serum amyloid A: a biomarker for renal cancer. Anticancer Res 32:1801–1804
Patel HD, Iyoha E, Pierorazio PM, Sozio SM, Johnson MH, Sharma R, Bass EB, Allaf ME (2016) A Systematic review of research gaps in the evaluation and management of localized renal masses. Urology 98:14–20
Escudier B, Eisen T, Stadler WM et al (2009) Sorafenib for treatment of renal cell carcinoma: final efficacy and safety results of the phase III treatment approaches in renal cancer global evaluation trial. J Clin Oncol Off J Am Soc Clin Oncol 27:3312–3318
Peña C, Lathia C, Shan M, Escudier B, Bukowski RM (2010) Biomarkers predicting outcome in patients with advanced renal cell carcinoma: results from sorafenib phase III Treatment Approaches in Renal Cancer Global Evaluation Trial. Clin cancer Res an Off J Am Assoc Cancer Res 16:4853–4863
Voss MH, Chen D, Marker M, Hakimi AA, Lee C-H, Hsieh JJ, Knox JJ, Voi M, Motzer RJ (2016) Circulating biomarkers and outcome from a randomised phase II trial of sunitinib vs everolimus for patients with metastatic renal cell carcinoma. Br J Cancer 114:642–649
Verkman AS, Hara-Chikuma M, Papadopoulos MC (2008) Aquaporins–new players in cancer biology. J Mol Med (Berl) 86:523–529
Morrissey JJ, London AN, Luo J, Kharasch ED (2010) Urinary biomarkers for the early diagnosis of kidney cancer. Mayo Clin Proc 85:413–421
Morrissey JJ, Mobley J, Figenshau RS, Vetter J, Bhayani S, Kharasch ED (2015) Urine aquaporin 1 and perilipin 2 differentiate renal carcinomas from other imaged renal masses and bladder and prostate cancer. Mayo Clin Proc 90:35–42
Song JB, Morrissey JJ, Mobley JM, Figenshau KG, Vetter JM, Bhayani SB, Kharasch ED, Figenshau RS (2019) Urinary aquaporin 1 and perilipin 2: Can these novel markers accurately characterize small renal masses and help guide patient management? Int J Urol Off J Japanese Urol Assoc 26:260–265
Gatto F, Maruzzo M, Magro C, Basso U, Nielsen J (2016) Prognostic value of plasma and urine glycosaminoglycan scores in clear cell renal cell carcinoma. Front Oncol 6:253
Biles M, Cheaib J, Obeid C, Parikh R, Becker R, Alam R, Metcalf M, Patel H, Pierorazio P (2020) Urinary biomarker panel to differentiate benign renal masses from aggressive and indolent renal cell carcinoma. Can J Urol 27:PDA-6 10
Linehan WM, Ricketts CJ (2013) The metabolic basis of kidney cancer. Semin Cancer Biol 23:46–55
Zheng H, Ji J, Zhao L, Chen M, Shi A, Pan L, Huang Y, Zhang H, Dong B, Gao H (2016) Prediction and diagnosis of renal cell carcinoma using nuclear magnetic resonance-based serum metabolomics and self-organizing maps. Oncotarget 7:59189–59198
Catchpole G, Platzer A, Weikert C et al (2011) Metabolic profiling reveals key metabolic features of renal cell carcinoma. J Cell Mol Med 15:109–118
Falegan OS, Ball MW, Shaykhutdinov RA, Pieroraio PM, Farshidfar F, Vogel HJ, Allaf ME, Hyndman ME (2017) Urine and serum metabolomics analyses may distinguish between stages of renal cell carcinoma. Metabolites. https://doi.org/10.3390/metabo7010006
Hakimi AA, Reznik E, Lee C-H et al (2016) An integrated metabolic atlas of clear cell renal cell carcinoma. Cancer Cell 29:104–116
Ball MW, Gorin MA, Guner G, Pierorazio PM, Netto G, Paller CJ, Hammers HJ, Diaz LA, Allaf ME (2016) Circulating tumor DNA as a marker of therapeutic response in patients with renal cell carcinoma: a pilot study. Clin Genitourin Cancer 14:e515–e520
Pal SK, Sonpavde G, Agarwal N et al (2017) Evolution of circulating tumor DNA profile from first-line to subsequent therapy in metastatic renal cell carcinoma. Eur Urol 72:557–564
Laganosky D, Lorentz C, Al-Qassab U et al (2017) Use of liquid biopsy for detection of renal cell carcinoma. J Clin Oncol 35:521
Turajlic S, Xu H, Litchfield K et al (2018) Deterministic evolutionary trajectories influence primary tumor growth: TRACERx renal. Cell 173:595-610.e11
McGillivray PD, Ueno D, Pooli A et al (2020) Distinguishing benign renal tumors with an oncocytic gene expression (ONEX) classifier. Eur Urol. https://doi.org/10.1016/j.eururo.2020.09.017
Di Meo A, Batruch I, Brown MD, Yang C, Finelli A, Jewett MA, Diamandis EP, Yousef GM (2020) Searching for prognostic biomarkers for small renal masses in the urinary proteome. Int J Cancer 146:2315–2325
Patel HD, Johnson MH, Pierorazio PM, Sozio SM, Sharma R, Iyoha E, Bass EB, Allaf ME (2016) Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol 195:1340–1347
Marconi L, Dabestani S, Lam TB et al (2016) Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol 69:660–673
Mitchell TJ, Turajlic S, Rowan A et al (2018) Timing the landmark events in the evolution of clear cell renal cell cancer: TRACERx renal. Cell 173:611-623.e17
Silagy AW, Sanchez A, Manley BJ, Bensalah K, Bex A, Karam JA, Ljungberg B, Shuch B, Hakimi AA (2019) Harnessing the genomic landscape of the small renal mass to guide clinical management. Eur Urol Focus 5:949–957
Author information
Authors and Affiliations
Contributions
SHP: Protocol/project development, manuscript writing/editing. NS: Manuscript writing/editing. PP: Protocol/project development, Manuscript writing/editing.
Corresponding author
Ethics declarations
Disclosure of potential conflicts of interest
None.
Research involving human participants and/or animals
Not applicable.
Informed consent
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Patel, S.H., Singla, N. & Pierorazio, P.M. Decision-making in active surveillance in kidney cancer: current trends and future urine and tissue markers. World J Urol 39, 2869–2874 (2021). https://doi.org/10.1007/s00345-021-03786-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-021-03786-3