Drangsholt Siri, Huang William C
Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, New York, NY 10016, USA.
Department of Urology, Perlmutter Cancer Center, NYU Langone Medical Center, 150 East 32nd Street, New York, NY 10016, USA.
Urol Clin North Am. 2017 May;44(2):169-178. doi: 10.1016/j.ucl.2016.12.003. Epub 2017 Mar 14.
There has been a rising incidence of small renal masses and concomitant downward stage migration. This has led to an evolution in the management of kidney cancer from radical nephrectomy to nephron-sparing treatment options including observation. The adoption of partial nephrectomy continues to increase but is still incomplete leading to significant disparities in the delivery of care throughout the country. Surgical excision remains the treatment of choice for small kidney cancers; however, ablative therapies and active surveillance are emerging as reasonable options for select patients. With continued refinements in treatment options and improvements in ability to risk stratify SRMs, the current treatment trends will likely continue to evolve.
小肾肿块的发病率不断上升，同时分期也在向下迁移。这导致了肾癌治疗方式从根治性肾切除术演变为保留肾单位的治疗选择，包括观察等待。部分肾切除术的应用持续增加，但仍未普及，导致全国范围内的医疗服务存在显著差异。手术切除仍然是小肾癌的首选治疗方法；然而，消融治疗和主动监测正成为部分患者的合理选择。随着治疗选择的不断完善以及对小肾肿块进行风险分层能力的提高，当前的治疗趋势可能会继续演变。
