Pierorazio Phillip M, Hyams Elias S, Mullins Jeffrey K, Allaf Mohamad E
Brady Urological Institute, Johns Hopkins University Baltimore, MD.
Rev Urol. 2012;14(1-2):13-9.
Small renal masses (SRMs; ≤ 4 cm in dimension) have rapidly risen in incidence in recent decades and pose an increasingly common management dilemma in urology. SRMs are biologically heterogeneous and a wide variety of treatments exist with favorable oncologic outcomes. Active surveillance (AS) has emerged as a viable option for those not desiring surgery or those who are suboptimal candidates for surgery, with < 2% of patients progressing to metastatic disease in retrospective and prospective studies. This article reviews the current data regarding AS for SRM, operational considerations for an AS program, and criteria for safely selecting patients for this treatment strategy.
小肾肿物（SRMs；直径≤4厘米）在近几十年的发病率迅速上升，给泌尿外科带来了日益常见的管理难题。SRMs在生物学上具有异质性，存在多种治疗方法且肿瘤学结局良好。对于那些不希望接受手术或手术条件欠佳的患者，主动监测（AS）已成为一种可行的选择，回顾性和前瞻性研究显示，进展为转移性疾病的患者不到2%。本文综述了目前关于SRM主动监测的相关数据、主动监测项目的操作考量以及安全选择适合该治疗策略患者的标准。
