Small renal masses management: a guidelines screenshot.
Small renal masses management: a guidelines screenshot.
Sachs C; d'Arienzo P, Nistri F, Barbisan D, Morana G
To review and compare the position of the major guidelines concerning small renal masses (T1) treatment with particular attention on thermal ablation and biopsy
Small renal masses have been a leading issue in the last decades due to their increased incidental diagnosis by imaging and the possibilities to manage them in different ways. Although scientific knowledge is constantly improving, a considerable discussion is still ongoing, contributing to an evolution of treatment management in time. The most recent and prominent urological and oncological guidelines from both Europe (EAU and ESMO) and America (CUA, AUA and NCCN) will be compared, focusing on the initial management (biopsy) and treatment options for small renal masses (nephrectomy, ablation or active surveillance), emphasizing the differences between them.
Table showing principal differences in the management of Bosniak cyst between European and American guidelines.
Table showing the main statements on major European (EAU, ESMO) and American (NCCN, AUA and CUA) guidelines about biopsy of small renal masses.
Table comparing the principal position of European and American guidelines about small renal masses surgery.
able reporting main statements of European guidelines about thermal ablation of small renal masses.
Table reporting main statements of American guidelines about thermal ablation of small renal masses.
Table showing European guidelines' principal statements about Active Surveillance.
Table showing American guidelines' principal statements about Active Surveillance.
According to all the guidelines, partial nephrectomy is the gold standard in RCC treatment. Despite the passage of time and several steps forward, the different guidelines still need to converge on several points regarding T1 renal masses management, underlying the necessity of more data to officially define the exact place for active surveillance, biopsy and thermal ablation. The American and European guidelines have slightly different directions, with Americans more open to initial active surveillance for small renal masses.
