Renal Mass and Localized Renal Cancer (2021): Difference between revisions
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*** '''<span style="color:#ff0000">Tumour factors (2)''' | *** '''<span style="color:#ff0000">Tumour factors (2)''' | ||
***# '''<span style="color:#ff0000">Solid renal mass < 2cm''' | ***# '''<span style="color:#ff0000">Solid renal mass < 2cm''' | ||
***# | ***#*'''<span style="color:#ff0000">In patients with familial RCC syndromes, tumours can be observed if <3 cm as the risk of metastases remains low in this setting</span>''' | ||
***# | ***#** '''<span style="color:#ff0000">HLRCC and succinate dehydrogenase deficiency RCC are the exception as tumors in these syndromes are often very aggressive.</span>''' | ||
***# '''<span style="color:#ff0000">Complex but predominantly cystic renal masses''' | ***# '''<span style="color:#ff0000">Complex but predominantly cystic renal masses''' | ||
*** '''<span style="color:#ff0000">Patient factors (7)''' | *** '''<span style="color:#ff0000">Patient factors (7)''' | ||
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***# '''<span style="color:#ff0000">Marginal renal function (≥CKD3b)''' | ***# '''<span style="color:#ff0000">Marginal renal function (≥CKD3b)''' | ||
***# '''<span style="color:#ff0000">Patient preference''' | ***# '''<span style="color:#ff0000">Patient preference''' | ||
***# | ***#* For patients who prefer AS in whom the | ||
***# | ***#**Risk/benefit analysis for treatment is equivocal, consider renal mass biopsy (if the mass is solid or has solid components) for further oncologic risk stratification. | ||
***# | ***#** Anticipated benefits of intervention outweigh the risks of treatment, AS with potential for delayed intervention may be only pursued if the patient understands and is willing to accept the associated risks. | ||
***# | ***#*** In this setting, renal mass biopsy (if the mass is predominantly solid) is encouraged for additional risk stratification. | ||
***# | ***#*** If the patient continues to prefer AS, close clinical and cross-sectional imaging surveillance with periodic reassessment and counseling should be recommended. | ||
* '''<span style="color:#ff0000">In patients undergoing AS, periodic clinical surveillance and/or imaging is recommended in asymptomatic patients</span>''' | * '''<span style="color:#ff0000">In patients undergoing AS, periodic clinical surveillance and/or imaging is recommended in asymptomatic patients</span>''' | ||
** '''Frequency and intensity are tailored to patient-risk,''' based on tumour size, tumor complexity, infiltrative appearance and median growth | ** '''Frequency and intensity are tailored to patient-risk,''' based on tumour size, tumor complexity, infiltrative appearance and median growth |