ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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2018
vol. 83
 
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abstract:
Review paper

Small renal carcinoma: the “when” and “how” of operation, active surveillance, and ablation

Jakob Johann Wendler, Bernd Uwe Liehr, Robert Damm, Maciej Powerski, Thomas Brunner, Martin Schostak, Maciej Pech

© Pol J Radiol 2018; 83: e595-e603
Online publish date: 2018/12/22
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Small, locally restricted renal cell carcinoma less than 4 cm in size should ideally be removed operatively by nephron-sparing tumour enucleation (partial kidney resection). In an increasingly elderly population, there is a growing trend toward parallel incidence of renal cell carcinoma and chronic renal insufficiency, with the latter’s associated general comorbidities. Thus, for some patients, the risks of the anaesthesia and operation increase, while the advantage in terms of survival decreases. Transcutaneous radio-frequency ablation under local anaesthesia, transcutaneous afterloading high-dose-rate brachytherapy under local anaesthesia, and percutaneous stereotactic ablative radiotherapy may offer a less invasive alternative therapy. Active surveillance is to be regarded as no more than a controlled bridging up to definitive treatment (operation or ablation), while watchful waiting, on account of the lack of prognostic relevance and the symptomatology of renal cell carcinoma, with its comorbidity-related, clearly reduced life expectancy, does not involve any further diagnostic or therapeutic measures.
keywords:

renal cell carcinoma, small renal tumour, active surveillance, ablation, focal therapy

 
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