Academic Journal
Optimizing management of small renal masses: a patient-centered approach to minimize overtreatment.
| Τίτλος: | Optimizing management of small renal masses: a patient-centered approach to minimize overtreatment. |
|---|---|
| Συγγραφείς: | Kitano G; Department of Urology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi JP 464-861, Japan., Kojima T; Department of Urology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi JP 464-861, Japan., Osawa T; Department of Urology and Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata JP 951-8510, Japan., Miyata H; Department of Urology, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, Hokkaido JP 060-8648, Japan., Numakura K; Department of Renal and Urologic Surgery Asahikawa, Medical University, 2-1-1-1 Midorigaoka-higashi, Asahikawa, Hokkaido JP 078-8510, Japan., Kitamura H; Department of Urology, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama JP 930-0194, Japan. |
| Πηγή: | Japanese journal of clinical oncology [Jpn J Clin Oncol] 2026 Aug 05; Vol. 56 (8), pp. 931-939. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: England NLM ID: 0313225 Publication Model: Print Cited Medium: Internet ISSN: 1465-3621 (Electronic) Linking ISSN: 03682811 NLM ISO Abbreviation: Jpn J Clin Oncol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford : Oxford University Press Original Publication: Tokyo, Foundation of Clinical Oncology. |
| Ιατρικοί όροι (MeSH): | Kidney Neoplasms*/pathology , Kidney Neoplasms*/therapy , Kidney Neoplasms*/surgery , Overtreatment*/prevention & control , Carcinoma, Renal Cell*/pathology , Carcinoma, Renal Cell*/therapy, Humans ; Watchful Waiting ; Patient-Centered Care ; Nephrectomy ; Patient Selection ; Radiosurgery ; Aged |
| Περίληψη: | Small renal masses (SRMs) usually have a favorable prognosis. Many studies have shown that cancer-specific survival (CSS) is comparable among various treatment options, such as partial nephrectomy, percutaneous thermal ablation, stereotactic body radiotherapy, and active surveillance (AS). Therefore, the choice of treatment should be based on patient background and tumor characteristics rather than on oncologic concerns alone. Important patient factors include age, comorbidities, renal function, and life expectancy. Tumor size, growth rate, and anatomical location also influence this decision. In older or frail patients, immediate intervention may represent overtreatment, as the risk of periprocedural complications and renal function loss may outweigh the limited oncological benefit. Recent AS studies have demonstrated excellent CSS and very low metastatic rates; however, many of these prospective cohorts included patients with limited life expectancies and relatively short follow-up periods, which limit their generalizability. This review summarizes the current evidence regarding local treatment options and surveillance strategies for SRMs, focusing on oncologic outcomes, renal function, and patient selection. Finally, we highlight the rationale and design of the ongoing JCOG2409 prospective comparative study in medically operable adults aged ≥75 years with a solitary renal mass that evaluates standardized AS versus upfront interventions. (© The Author(s) 2026. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Contributed Indexing: | Keywords: JCOG2409; ablation therapy; active surveillance; renal cell carcinoma; small renal masses; stereotactic body radiotherapy |
| Entry Date(s): | Date Created: 20260502 Date Completed: 20260805 Latest Revision: 20260805 |
| Update Code: | 20260806 |
| DOI: | 10.1093/jjco/hyag069 |
| PMID: | 42068570 |
| Βάση Δεδομένων: | MEDLINE |
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