Small renal mass: To treat or not to treat

Ahmed Alasker, Steve K. Williams, Reza Ghavamian

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


An increasing number of small renal masses (SRMs) are being detected with modern cross-sectional imaging. The natural history of SRMs is mostly unknown. Initial active surveillance (AS) is a reasonable treatment option for small renal masses (SRMs) < 4 cm in the infirm patient with major comorbidities. Partial nephrectomy (PN) is the established treatment for T1a tumors, provided that the operation is technically feasible and the tumor can be completely removed. Laparoscopic and, most recently, robotic PN have functional and oncologic outcomes comparable to open PN, but are technically demanding procedures. Radical nephrectomy (RN) should be limited to those cases where the tumor is not amenable to PN. Percutaneous needle biopsy of SRMs can be safely performed and has the potential to characterize SRMs histologically. It is best utilized in conjunction with ablative technologies. However, ablative therapies should be reserved for carefully selected patients who are poor surgical candidates.

Original languageEnglish (US)
Pages (from-to)13-18
Number of pages6
JournalCurrent urology reports
Issue number1
StatePublished - Feb 2013


  • Active surveillance
  • Cryoablation
  • Localized renal cellular carcinoma
  • Partial nephrectomy
  • Radiofrequency ablation
  • Robotic-assisted laparoscopic nephrectomy
  • Small renal masses

ASJC Scopus subject areas

  • Urology


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