Department of Urology, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
Curr Urol Rep. 2014 Mar;15(3):386. doi: 10.1007/s11934-013-0386-x.
Up to 66 % of renal cell carcinomas are detected as small renal masses before the presence of clinical symptoms. Small renal mass treatment has evolved from the exclusive use of radical nephrectomy to the use of nephron sparing procedures where possible. An increase in elderly and comorbid patients, together with the notion that just 20 % of small renal masses show high malignant potential, has prompted interest in active surveillance as a treatment option. Modern imaging techniques provide objective follow-up parameters, namely size, invasion of collecting system or perirenal fat and enhancement patterns, with minimal complication risks or patient discomfort. This review evaluates recent developments in the field of active surveillance for small renal masses. Special focus is placed on the role of imaging in the primary decision making and subsequent follow-up during active surveillance.
多达 66%的肾细胞癌在出现临床症状之前被检测为小的肾肿瘤。小的肾肿瘤的治疗已经从单纯的根治性肾切除术发展到尽可能使用保留肾单位的手术。老年和合并症患者的增加，以及只有 20%的小肾肿瘤显示出高恶性潜能的观念，促使人们对主动监测作为一种治疗选择产生了兴趣。现代成像技术提供了客观的随访参数，即大小、集合系统或肾周脂肪的侵犯以及增强模式，其并发症风险或患者不适最小。本综述评估了小的肾肿瘤主动监测领域的最新进展。特别关注的是影像学在主动监测的初始决策和后续随访中的作用。
