Frances M. Alba, MD, presented “Active Surveillance of Renal Mass” at the 27th Annual Innovations in Urologic Practice conference on September 22nd, 2023.
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How to cite: Alba, Frances M. “Active Surveillance of Renal Mass.” September 2023. Accessed Apr 2024. https://grandroundsinurology.com/active-surveillance-of-renal-mass/
Active Surveillance of Renal Mass – Summary
Frances M. Alba, MD, discusses the benefits of active surveillance of small renal masses (SRM) as a treatment option. Dr. Alba begins by presenting data that most SRM have low or very low malignant potential. Despite this, SRM are removed routinely without preoperative pathologic diagnosis and Dr. Alba asserts this raises the question of significant overtreatment.
Dr. Alba then addresses metastasis, explaining that risk of metastases is exceedingly low for SRM. She describes a prediction calculator to support personalized treatment selection and explains that regardless of treatment, the vast majority of patients will die of other causes. She emphasizes overall survival is influenced by patient risk factors.
Dr. Alba addresses quality-of-life issues for patients being treated with active surveillance, including the impact of illness uncertainty. She covers trends in active surveillance before outlining her recommendations, suggesting an initial period of six months to establish a trend. She advises asking patients about fears, concerns, and life events. She points out that active surveillance can be used to delay intervention in patients with competing medical or life issues and delayed intervention is safe.
Dr. Alba concludes by emphasizing that active surveillance is the ultimate nephron-sparing management modality and patients can be managed conservatively with serial imaging. Dr. Alba reminds practitioners that intervention for SRM imposes physical, emotional, mental, and financial burdens on patients and families, and that active surveillance can alleviate many of these concerns.
About The 27th Annual Innovations in Urologic Practice:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma; men’s health topics like male infertility, andrology, and sexual dysfunction; OAB and voiding dysfunctions; and ways to diagnose and treat infections in the urology patient.
For further educational activities from this conference, visit our collection page.
