Dräger Désirée Louise, Rojas Cruz Cesar, Held Jascha, Niepel Ferry, Zimpfer Annette, Hakenberg Oliver W
Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
Institut für Pathologie, Universitätsmedizin Rostock, Rostock, Deutschland.
Urologie. 2024 Dec;63(12):1217-1223. doi: 10.1007/s00120-024-02471-8. Epub 2024 Nov 6.
Small renal masses (SRM) are a heterogeneous group of tumors with varying metastatic potential. The increasing use and improvement in the quality of abdominal imaging have led to an increasingly earlier diagnosis of incidental SRM, which are asymptomatic and confined to the organ. Despite these advances in imaging and the growing use of renal tumor biopsies, preoperative diagnosis of malignancy remains difficult. The treatment of SRM has shifted away from radical nephrectomy and now primarily includes organ-sparing surgery or active surveillance. The optimal strategy for treating SRM is continuously evolving as studies from prospective data registries can identify factors that influence both short- and long-term patient outcomes. Recent research on biomarkers, imaging techniques, and machine learning offer promising approaches to a deeper understanding of tumor biology and treatment options for this patient population.
小肾肿块(SRM)是一组异质性肿瘤,具有不同的转移潜能。腹部影像学检查的使用增加以及质量的提高,使得偶然发现的无症状且局限于器官内的SRM越来越早地被诊断出来。尽管影像学有这些进展,且肾肿瘤活检的使用越来越多,但术前诊断恶性肿瘤仍然困难。SRM的治疗已从根治性肾切除术转变,现在主要包括保留器官手术或主动监测。随着前瞻性数据登记研究能够确定影响患者短期和长期预后的因素,治疗SRM的最佳策略也在不断演变。最近关于生物标志物、成像技术和机器学习的研究为更深入了解该患者群体的肿瘤生物学和治疗选择提供了有前景的方法。