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小肾肿块的诊断和治疗:我们处于什么位置?

Diagnosis and Treatment of Small Renal Masses: Where Do We Stand?

机构信息

Hospital Clínico San Carlos, Complutense, University of Madrid, Madrid, Spain.

Department of Urology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

出版信息

Curr Urol Rep. 2022 Jun;23(6):99-111. doi: 10.1007/s11934-022-01093-x. Epub 2022 May 4.

Abstract

PURPOSE OF REVIEW

To present an overview of the current evidence-based studies covering diagnostic and management of SRM.

RECENT FINDINGS

Renal cell carcinoma (RCC) represents 3% of the cancers. Nowadays, partial nephrectomy (PN) represents gold standard treatment. New nephron-sparing approaches such as active surveillance and ablative therapies have been increasingly used as an alternative to surgical intervention. Due to novel comprehension of RCC and widespread use of imaging techniques, diagnosis at early stage in elderly patients has increased. Treatment decision-making should be based on patient and tumour characteristics. With expanding treatment options, the management of SRMs has become a debate and should be adjusted to patient and tumour characteristics. In a shared decision manner, both active surveillance with possible delayed intervention and focal therapy should be discussed with the patient as an alternative to partial nephrectomy.

摘要

目的综述

介绍目前基于循证的研究,涵盖了 SRM 的诊断和治疗。

最新发现

肾细胞癌(RCC)占所有癌症的 3%。目前,部分肾切除术(PN)是金标准治疗方法。新的保肾方法,如主动监测和消融治疗,已越来越多地被用作手术干预的替代方法。由于对 RCC 的新认识和成像技术的广泛应用,老年患者的早期诊断有所增加。治疗决策应基于患者和肿瘤的特征。随着治疗选择的扩大,对 SRM 的管理已成为一个争论的问题,应根据患者和肿瘤的特征进行调整。以共同决策的方式,应与患者讨论主动监测和可能的延迟干预以及局部治疗作为部分肾切除术的替代方案。

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