The Journal of Urology
Volume 182, Issue 4 , Pages 1271-1279 , October 2009

Guideline for Management of the Clinical T1 Renal Mass

  • Steven C. Campbell

      Affiliations

    • Corresponding Author InformationCorrespondence: Section of Urologic Oncology, Glickman Urological and Kidney Institute, Glickman Tower, 9500 Euclid Ave., Cleveland Clinic, Cleveland, Ohio 44195 (telephone: 216-444-5595; FAX: 216-636-0770)
    • Financial interest and/or other relationship with Pfizer, Sanofi Aventis, Novartis, Aventis Pharmaceuticals.
  • ,
  • Andrew C. Novick

      Affiliations

    • The Panel dedicates this work to Dr. Andrew Novick, who served as Chair of the Panel until his untimely death in 2008. Dr. Novick was well recognized for his contributions to renal surgery, and kidney cancer in particular.
  • ,
  • Arie Belldegrun

      Affiliations

    • Financial interest and/or other relationship with Galil Medical, Wilex, Bayer, Pfizer, ROEI Medical, Amgen, Agensys, Hana Biosciences, Cougar Biotechnology.
  • ,
  • Michael L. Blute
  • ,
  • George K. Chow
  • ,
  • Ithaar H. Derweesh
  • ,
  • Martha M. Faraday
  • ,
  • Jihad H. Kaouk

      Affiliations

    • Financial interest and/or other relationship with Endocare, Intuitive Surgical.
  • ,
  • Raymond J. Leveillee

      Affiliations

    • Financial interest and/or other relationship with Pluromed, LMA Urology-Suisee, Boston Scientific, ACMI, Applied Medial, ValleyLab, Ethicon, Intuitive Surgical.
  • ,
  • Surena F. Matin

      Affiliations

    • Financial interest and/or other relationship with Johnson & Johnson Wound Management.
  • ,
  • Paul Russo

      Affiliations

    • Financial interest and/or other relationship with Wilex AG.
  • ,
  • Robert G. Uzzo

      Affiliations

    • Financial interest and/or other relationship with Pfizer, Bayer.

References 

  1. Green FL. Kidney. In:  Page DL,  Batch CM,  Fleming ID, et al. editor. AJCC Cancer Staging Manual. New York: Springer Verlag; 2002;p. 323–328
  2. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71
  3. Mathew A, Devesa SS, Fraumeni JF, et al. Global increases in kidney cancer incidence, 1973–1992. Eur J Cancer Prev. 2002;11:171
  4. Jayson M, Sanders H. Increased incidence of serendipitously discovered renal cell carcinoma. Urology. 1998;51:203
  5. Kutikov A, Fossett LK, Ramchandani P, et al. Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. BJU Int. 2008;68:737
  6. Snyder ME, Bach A, Kattan MW, et al. Incidence of benign lesions for clinically localized renal masses smaller than 7 cm in radiological diameter: influence of sex. J Urol. 2006;176:2391
  7. Pahernik S, Ziegler S, Roos F, et al. Small renal tumors: correlation of clinical and pathological features with tumor size. J Urol. 2007;178:414
  8. Remzi M, Ozsoy M, Klingler HC, et al. Are small renal tumors harmless? (Analysis of histopathological features according to tumors 4 cm or less in diameter). J Urol. 2006;176:896
  9. Hollenbeck BK, Taub DA, Miller DC, et al. National utilization trends of partial nephrectomy for renal cell carcinoma: a case of under utilization?. Urology. 2006;67:254
  10. Clayman RV, Kavoussi LR, Soper NJ. Laparoscopic nephrectomy: Initial case report. J Urol. 1991;146:278
  11. Russo P. Open radical nephrectomy for localized renal cell carcinoma. In:  Vogelzang NJ, et al. editor. Comprehensive Textbook of Genitourinary Oncology. Philadelphia: Lippincott, Williams & Wilkins; 2002;p. 725–731
  12. Dunn MD, Portis AJ, Shalhav AL. Laparoscopic versus open radical nephrectomy: 9-year experience. J Urol. 2000;164:1153
  13. Nadler RB, Loeb S, Clemens JQ, et al. A prospective study of laparoscopic radical nephrectomy for T1 tumors–is transperitoneal, retroperitoneal or hand assisted the best approach?. J Urol. 2006;175:1230
  14. McKiernan J, Simmons R, Katz J, et al. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59:816
  15. Thompson RH, Boorjian SA, Lohse CM, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared to partial nephrectomy. J Urol. 2008;179:468
  16. Lee CT, Katz J, Shi W, et al. Surgical management of renal tumors 4 cm. or less in a contemporary cohort. J Urol. 2000;163:730
  17. Lau WK, Blute ML, Weaver AL, et al. Matched comparison of radical nephrectomy vs. nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc. 2000;75:1236
  18. Leibovich BC, Blute ML, Cheville JC, et al. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol. 2004;171:1066
  19. Dash A, Vickers AJ, Schachter LR. Comparison of outcomes in elective partial vs. radial nephrectomy for clear cell renal cell carcinoma of 4 to 7 cm. BJU Int. 2006;97:939
  20. Gill IS, Kavoussi LR, Lane BR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178:41
  21. Kunkle DA, Egleston BL, Uzzo RG. Cryoablation versus radio frequency ablation of the small renal mass: a meta-analysis of published literature. J Urol. 2008;179:328
  22. Gill IS, Remer EM, Hasan WA, et al. Renal cryoablation: outcome at 3 years. J Urol. 2005;173:1903
  23. Davol PE, Fulmer BR, Rukstalis DB. Long-term results of cryoablation for renal cancer and complex renal masses. Urology. 2006;68:2
  24. Matin SF, Ahrar K, Cadeddu JA, et al. Residual and recurrent disease following renal energy ablative therapy: a multi-institutional study. J Urol. 2006;176:1973
  25. Oda T, Miyao N, Takahashi A, et al. Growth rates of primary and metastatic lesions of renal cell carcinoma. Int J Urol. 2001;8:473
  26. Chawla SN, Crispen PL, Hanlon AL, et al. The natural history of observed enhancing renal masses: meta-analysis and review of the world. J Urol. 2006;175:425
  27. Bosniak MA, Birnbaum BA, Krinsky GA, et al. Small renal parenchymal neoplasms: further observations on growth. Radiology. 1995;197:589
  28. Kunkle DA, Crispen PL, Chen DY, et al. Enhancing renal masses with zero net growth during active surveillance. J Urol. 2007;177:849
  29. Lamb GW, Bromwich EJ, Vasey P, et al. Management of renal masses in patients medically unsuitable for nephrectomy–natural history, complications, and outcome. Urology. 2004;64:909
  30. Huang WC, Levey AS, Serio AM, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7:735
  31. Van Poppel H, Pozzo LD, Albrecht W, et al. A prospective randomized EORTC intergroup phase 3 study comparing the complications of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2007;51:1606
  32. Goldberg SN, Grassi CJ, Cardella JF, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. Radiology. 2005;235:728
  33. Kunkle DA, Egleston BL, Uzzo RG. Excise, ablate or observe: the small renal mass dilemma—a meta-analysis and review. J Urol. 2008;179:1227
  34. Nguyen CT, Lane BR, Kaouk JH, et al. Surgical salvage of renal cell carcinoma recurrence after thermal ablative therapy. J Urol. 2008;180:104
  35. Kowalczyk KJ, Hooper HB, Linehan MW, et al. Outcomes of partial nephrectomy after previous radiofrequency ablation: the NCI experience. J Urol, suppl. 2008;179:214;abstract 609
  36. Weight CJ, Kaouk JH, Hegarty NJ, et al. Correlation of radiographic imaging and histopathology following cryoablation and radio frequency ablation for renal tumors. J Urol. 2008;179:1277
  37. Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296
  38. Crispen PL, Viterbo R, Fox EB, et al. Delayed intervention of sporadic renal masses undergoing active surveillance. Cancer. 2008;112:1051
  39. Sowery RD, Siemens DR. Growth characteristics of renal cortical tumors in patients managed by watchful waiting. Can J Urol. 2004;11:2407
  40. Frank I, Blute ML, Cheville JC, et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol. 2003;170:2217

 This document is being reprinted as submitted without editorial or independent peer review by the Editors of The Journal of Urology®.

 The complete document is available at http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/renalmass09.pdf.

 Requests for reprints: Guidelines Department, American Urological Association, 1000 Corporate Blvd., Linthicum, Maryland 21090.

 For other articles on a related topic see pages 1582, 1588 and 1594.

PII: S0022-5347(09)01728-5

doi: 10.1016/j.juro.2009.07.004

The Journal of Urology
Volume 182, Issue 4 , Pages 1271-1279 , October 2009