Liaw Christine W, Winoker Jared S, Mehrazin Reza
Department of Urology at the Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY, 10029, USA.
Curr Urol Rep. 2018 Aug 13;19(10):81. doi: 10.1007/s11934-018-0830-z.
To review the growth kinetics of small renal masses and available imaging modalities for mass characterization and surveillance, highlight current organizational recommendations for the active surveillance of small renal masses, and discuss the most recently reported oncological outcomes of patients as they relate to various surveillance imaging protocols and progression to delayed intervention.
Overall, organizational guideline recommendations are broad and lack specifics regarding timing and modality for follow-up imaging of small renal masses. Additionally, despite general consensus in the literature about certain criteria to trigger delayed intervention, there exist no formal guidelines. Active surveillance of small renal masses is an acceptable management strategy for patients with prohibitive surgical risk; however, standardized imaging protocols for surveillance are lacking, as are randomized, prospective trials to evaluate the ideal follow-up protocol.
回顾小肾肿块的生长动力学以及用于肿块特征描述和监测的现有成像方式,强调当前关于小肾肿块主动监测的组织性建议,并讨论最近报道的患者肿瘤学结局,这些结局与各种监测成像方案以及延迟干预的进展情况相关。
总体而言,组织性指南建议较为宽泛,缺乏关于小肾肿块随访成像的时间安排和方式的具体内容。此外,尽管文献中对于触发延迟干预的某些标准已达成普遍共识,但尚无正式指南。对于手术风险过高的患者,小肾肿块的主动监测是一种可接受的管理策略;然而,缺乏用于监测的标准化成像方案,也缺乏评估理想随访方案的随机前瞻性试验。