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Management of small renal masses: a review.
Remzi, Mesut; Javadli, Elchin; Ozsoy, Mehmet.
Afiliação
  • Remzi M; Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. mRemzi@gmx.at
World J Urol ; 28(3): 275-81, 2010 Jun.
Article em En | MEDLINE | ID: mdl-20177900
INTRODUCTION: Recently, small renal masses (SRMs) (< or =4 cm) are found more frequently, especially in the elderly and co-morbid patients. Standard treatment for SRMs is nephron-sparing surgery (NSS). New techniques like energy ablation and surveillance have been introduced. MATERIALS AND METHODS: Overview of treatment options for SRMs, based mainly on the meta-analyses available for NSS, cryoablation, radio-frequency ablation (RFA), and surveillance. RESULTS: NSS for SRMs is the standard therapy with excellent cancer-specific survival rates up to 97%. Cryoablation was mainly performed laparoscopically, and RFA mainly percutaneously. Pretreatment biopsies were used frequently for cryoablation (80%) and less frequently for RFA (50%). Primary failure rate for cryoablation was 4.8% and for RFA 13%. Major complication rates for both procedures are around 5%. Based on 6-month post-ablative biopsies, non-contrast enhancement seems to be an effective surrogate marker after cryoablation, but not after RFA. Follow-up after energy ablation is too short to draw final conclusion. Data on surveillance are based on small, retrospective data with insufficient follow-up. Growth patterns during follow-up do not correlate with the underlying tumour entity. CONCLUSION: Standard therapy for SRMs is still NSS. Energy ablation should be reserved for the elderly patients with co-morbidities and surveillance for the elderly and infirm patients.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Minimamente Invasivos / Neoplasias Renais Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: World J Urol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Minimamente Invasivos / Neoplasias Renais Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: World J Urol Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Áustria País de publicação: Alemanha