Boorjian Stephen A, Uzzo Robert G
Department of Surgery, Fox Chase Cancer Center, 8 Huntingdon Pike, Rockledge, PA 19046, USA.
Curr Oncol Rep. 2009 May;11(3):211-7. doi: 10.1007/s11912-009-0030-6.
The incidence of small renal masses (SRMs) continues to rise, largely because of the widespread use of cross-sectional imaging for abdominal symptomatology. Clinical management must balance the risk of disease progression from renal cell carcinoma in these tumors against the potential morbidity of treatment, particularly in elderly patients or those with multiple comorbidities. Moreover, a significant minority of SRMs represent benign lesions. This article reviews the current data for surgical excision, cryoablation, radiofrequency ablation, and active surveillance of SRMs. Surgical excision, predominantly in the form of nephron-sparing surgery, remains the standard of care because of its durable oncologic and favorable functional outcomes. Active surveillance and ablative technologies have emerged as alternatives to surgery in select patients based on short-term oncologic data. Nevertheless, the extent to which treatment alters the natural history of SRMs has yet to be established.
小肾肿物（SRMs）的发病率持续上升，主要原因是横断面成像技术在腹部症状诊断中的广泛应用。临床管理必须在这些肿瘤发生肾细胞癌疾病进展的风险与治疗潜在的发病率之间取得平衡，尤其是在老年患者或患有多种合并症的患者中。此外，相当一部分小肾肿物代表良性病变。本文综述了小肾肿物手术切除、冷冻消融、射频消融及主动监测的当前数据。手术切除，主要是以保留肾单位手术的形式，因其持久的肿瘤学效果和良好的功能预后，仍然是治疗的标准方法。基于短期肿瘤学数据，主动监测和消融技术已成为特定患者手术的替代方法。然而，治疗改变小肾肿物自然病程的程度尚未明确。
