Management of Small Renal Masses: American Society of Clinical Oncology Clinical Practice Guideline.

Autor: Finelli A; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Ismaila N; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Bro B; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Durack J; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Eggener S; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Evans A; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Gill I; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Graham D; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Huang W; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Jewett MA; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Latcha S; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Lowrance W; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Rosner M; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Shayegan B; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Thompson RH; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Uzzo R; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA., Russo P; Antonio Finelli and Michael A.S. Jewett, Princess Margaret Cancer Center; Andrew Evans, University Health Network, Toronto; Bobby Shayegan, St Joseph Hospital, Hamilton, Ontario, Canada; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria; Mitchell Rosner, University of Virginia School of Medicine, Charlottesville, VA; Bill Bro, Kidney Cancer Association; Scott Eggener, University of Chicago, Chicago, IL; Jeremy Durack, Sheron Latcha, and Paul Russo, Memorial Sloan Kettering Cancer Center; William Huang, New York University Langone Medical Center, New York, NY; Inderbir Gill, University of Southern California, Los Angeles, CA; David Graham, Levine Cancer Institute, Charlotte, NC; William Lowrance, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT; R. Houston Thompson, Mayo Clinic, Rochester, MN; and Robert Uzzo, Fox Chase Cancer Center, Philadelphia, PA.
Jazyk: angličtina
Zdroj: Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2017 Feb 20; Vol. 35 (6), pp. 668-680. Date of Electronic Publication: 2017 Jan 17.
DOI: 10.1200/JCO.2016.69.9645
Abstrakt: Purpose To provide recommendations for the management options for patients with small renal masses (SRMs). Methods By using a literature search and prospectively defined study selection, we sought systematic reviews, meta-analyses, randomized clinical trials, prospective comparative observational studies, and retrospective studies published from 2000 through 2015. Outcomes included recurrence-free survival, disease-specific survival, and overall survival. Results Eighty-three studies, including 20 systematic reviews and 63 primary studies, met the eligibility criteria and form the evidentiary basis for the guideline recommendations. Recommendations On the basis of tumor-specific findings and competing risks of mortality, all patients with an SRM should be considered for a biopsy when the results may alter management. Active surveillance should be an initial management option for patients who have significant comorbidities and limited life expectancy. Partial nephrectomy (PN) for SRMs is the standard treatment that should be offered to all patients for whom an intervention is indicated and who possess a tumor that is amenable to this approach. Percutaneous thermal ablation should be considered an option if complete ablation can reliably be achieved. Radical nephrectomy for SRMs should only be reserved for patients who possess a tumor of significant complexity that is not amenable to PN or for whom PN may result in unacceptable morbidity even when performed at centers with expertise. Referral to a nephrologist should be considered if chronic kidney disease (estimated glomerular filtration rate < 45 mL/min/1.73 m 2 ) or progressive chronic kidney disease occurs after treatment, especially if associated with proteinuria.
Databáze: MEDLINE