Delay in Nephrectomy and Cancer Control Outcomes in Elderly Patients with Small Renal Masses

2014 ◽  
Vol 92 (4) ◽  
pp. 455-461 ◽  
Author(s):  
Andreas Becker ◽  
Florian Roghmann ◽  
Praful Ravi ◽  
Zhe Tian ◽  
Luis Alexander Kluth ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cancer Control ◽  
Small Renal Masses ◽  
Renal Masses

scholarly journals Review of the efficacy and safety of radiofrequency ablation for the treatment of small renal masses

2013 ◽  
Vol 3 (2) ◽  
pp. 143 ◽  
Author(s):  
Regina El Dib ◽  
Naji J. Touma ◽  
Anil Kapoor
Keyword(s):  
Clinical Trials ◽  
Radiofrequency Ablation ◽  
Tumour Size ◽  
Treatment Algorithm ◽  
Case Series ◽  
Cancer Control ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Small Renal Masses ◽  
Renal Masses

Background: Small renal masses are increasingly being discoveredincidentally on imaging performed for another reason. Thestandard of care for these masses involves excision by open orlaparoscopic techniques. Recently, ablative techniques such asradiofrequency ablation (RFA) and cryoablation have taken a moreprominent role in the treatment algorithm for these masses. Wesought to evaluate the efficacy and safety of radiofrequency ablationin the treatment of renal tumours.Methods: We conducted a review of the literature. There was nolanguage restriction. We obtained studies from the followingsources: the Cochrane Library, PubMed, EMBASE, LILACS andCurrent Controlled Trials.Results: We identified no clinical trials in the literature. Thus wedescribed the results from case series and retrospective studieswith a reasonable sample size (number of reported patients in eachstudy > 65). Most patients undergoing RFA had T1a disease witha mean tumour size of about 3 cm. Radiofrequency ablation wasusually performed percutaneously with image guidance. Reportedfollow-up was short and ranged from 1 to 30 months. Most seriesused radiographic response as a surrogate for cancer control. Therates of local recurrence of the tumour were as high as 13.0%(average 8.5%) and were slightly higher than those associated withcryoablation and partial nephrectomy. Complications includedhemorrhage, ureteral strictures and loss of a renal unit.Conclusion: Our review demonstrates that RFA is a suitable andpromising therapy in patients with small renal tumours who areconsidered to be poor candidates for more involved surgery.However, clinical trials with long-term data are needed to establishthe oncological efficacy.Contexte : De petites masses rénales sont de plus en plus souventdécouvertes de façon fortuite lors d’épreuves d’imagerie commandéespour une autre raison. Les soins standard pour ces massesincluent une excision par chirurgie ouverte ou par laparoscopie.Dernièrement, des techniques comme l’ablation par radiofréquence(ARF) et la cryoablation ont pris plus d’importance dans l’algorithmede traitement. Nous examinons l’efficacité et l’innocuité del’ablation par radiofréquence dans le traitement des tumeurs rénales.Méthodologie : Une revue de la littérature a été effectuée, sansrestriction de langue. Des articles ont été obtenus des sources suivantes: la Bibliothèque Cochrane, PUBMED, EMBASE, LILACS etCurrent Controlled Trials.Résultats : Comme aucun essai clinique n’a pu être cerné dans cesbases de données, nous décrivons les résultats d’études de cas etd’analyses rétrospectives avec populations de taille raisonnable(nombre de patients pour chaque étude > 65). La vaste majoritédes patients ayant subi une ARF présentaient une tumeur T1a detaille moyenne d’environ 3 cm. L’ARF était habituellement effectuéepar voie percutanée et guidée par imagerie. Le suivi était court,allant de 1 à 30 mois. La plupart des études sérielles avaient recoursà la réponse radiographique comme paramètre de substitutionde la maîtrise du cancer. Les taux de récidive locale de la tumeuratteignaient 13.0 % (moyenne 8.5%), et étaient en général légèrementplus élevés que les taux notés avec la cryoablation et lanéphrectomie partielle. Les complications signalées étaient les suivantes: hémorragie, sténose urétérale et perte d’une unité rénale.Conclusion : Le présent article montre que l’ARF est une techniqueconvenable et prometteuse chez les patients porteurs depetites tumeurs rénales considérés comme de mauvais candidatspour une intervention plus lourde. Cependant, il est impératifd’effectuer des essais cliniques à long terme afin d’établir dans unavenir rapproché l’efficacité oncologique de cette technique.

scholarly journals The effect of age on cancer-specific mortality in patients with small renal masses: A population-based analysis

2018 ◽  
Vol 12 (7) ◽  
pp. E325-30 ◽  
Author(s):  
Marco Bandini ◽  
Michele Marchioni ◽  
Raisa S. Pompe ◽  
Zhe Tian ◽  
Tristan Martel ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Large Population ◽  
Population Based ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Fuhrman Grade ◽  
Hazard Ratios ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Effect Of Age

Introduction: Contemporary data regarding the effect of age, especially in elderly patients, on cancer-specific mortality (CSM) for pT1a renal cell carcinoma (RCC) are lacking. The objective of the current study is to evaluate CSM in a large population-based cohort of surgically treated pT1a RCC patients according to age groups.Methods: Within the Surveillance Epidemiology and End Results database (2000‒2013), we identified 37 121 pT1a RCC patients who underwent either partial or radical nephrectomy. The population was stratified into five groups according to decades: <50, 50‒59, 60‒69, 70‒79, and ≥80 years. The effect of age on CSM was evaluated using competing risks regression models according to Fuhrman grade (FG). Analyses were repeated in clear-cell RCC (ccRCC).Results: Patients aged 50‒59 (9615), 60‒69 (10 762), 70‒79 (7096), and ≥80 (1789) years demonstrated higher rate of CSM compared to patients aged <50 (7856) years (hazard ratios [HR] 2.11, 3.04, 4.47, and 7.56, respectively; all p<0.001). The effect of age on CSM in FG 1‒2 patients resulted in HRs ranging from 2.01‒8.23 for the same age decades (all p< 0.001). Similarly, the effect of age on CSM in FG 3‒4 patients resulted in HRs ranging from 2.38‒5.92, respectively (all p<0.001). Virtually the same results were recorded in ccRCC patients.Conclusions: Older age is associated with higher CSM in surgically treated patients with pT1a RCC. This effect seems to be more pronounced in patient with FG 1‒2 disease. This observation should be considered when making treatment decisions in elderly patients.

scholarly journals Review of the efficacy and safety of cryoablation for the treatment of small renal masses

2013 ◽  
Vol 7 (1-2) ◽  
pp. 38 ◽  
Author(s):  
Anil Kapoor ◽  
Naji J. Touma ◽  
Regina El Dib
Keyword(s):  
Treatment Algorithm ◽  
Case Series ◽  
Cancer Control ◽  
Standard Of Care ◽  
Cochrane Library ◽  
Success Rates ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Perinephric Hematoma ◽  
Ablative Techniques

Purpose: Small renal masses are increasingly being discovered incidentally on imaging for another reason. The standard of care of these masses involves excision by open or laparoscopic techniques. Recently, ablative techniques, such as radiofrequency ablation (RFA) and cryoablation, have taken a more prominent role in the treatment algorithm of these masses. We evaluate the effectiveness and safety of cryoablation to treat renal tumours.Methods: A review of the literature was conducted. There was no language restriction. Studies were obtained from the following sources: the Cochrane Library, PUBMED, EMBASE and LILACS.Results: There was no clinical trial identified in the literature. Thus, we described the results from 23 case series and retrospective studies with a reasonable sample size (number of reported patients in each study ≥30), with a total of 2104 analyzed tumours from 2038 patients. There was wide variability in the outcomes reported, but success rates were generally good. Follow-up was generally short, but some series reported outcomes at 5 years. The most common complications reported were hemorrhage (some of the patients requiring transfusion), perinephric hematoma and urine leaks.Conclusion: Cryoablation presents a feasible treatment for patients with small renal masses. Only short-term data are available and, assuch, meaningful conclusions regarding long-term cancer control cannot be made. More rigorous studies are needed.

Ablation of Small Renal Masses

2020 ◽  
Vol 23 (2) ◽  
pp. 100674
Author(s):  
Mohamed E. Abdelsalam ◽  
Kamran Ahrar
Keyword(s):  
Small Renal Masses ◽  
Renal Masses

V708: Partial Nephrectomy for Small Renal Masses: An Emerging Quality of Care Concern?

2006 ◽  
Vol 175 (4S) ◽  
pp. 229-229
Author(s):  
David C. Miller ◽  
John M. Hollingsworth ◽  
Khaled S. Hafez ◽  
Stephanie Daignault ◽  
Brent K. Hollenbeck
Keyword(s):  
Quality Of Care ◽  
Partial Nephrectomy ◽  
Small Renal Masses ◽  
Renal Masses

1920: Variability in Size Measurement of Small Renal Masses on CT Imaging

2004 ◽  
Vol 171 (4S) ◽  
pp. 507-507 ◽  
Author(s):  
Sanoj P. Punnen ◽  
Massoom A. Haider ◽  
Fenella Moulding ◽  
Martin O'Malley ◽  
Gina Lockwood ◽  
...  
Keyword(s):  
Ct Imaging ◽  
Size Measurement ◽  
Small Renal Masses ◽  
Renal Masses

Triggers for delayed intervention in patients with small renal masses undergoing active surveillance: a systematic review

2020 ◽  
Vol 72 (4) ◽  
Author(s):  
Riccardo Campi ◽  
Francesco Sessa ◽  
Francesco Corti ◽  
Diego M. Carrion ◽  
Andrea Mari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Active Surveillance ◽  
Small Renal Masses ◽  
Renal Masses ◽  
Delayed Intervention
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