Surgery or observation for small renal masses in older patients?

Abstract

Surgery is the standard treatment for renal cell carcinoma; however, radical nephrectomy for lesions >4 cm may be considered overtreatment as well as nephron-sparing surgery for smaller tumors. Elderly people with small renal tumors are 3.5 times more likely to have a benign lesion than younger patients; hence, careful monitoring may be considered, together with repeated bioptic sampling. Percutaneous radio-frequency ablation or cryoablation could be alternative options although no long-term follow-up data is presently available. New molecular genetic profiling techniques will hopefully be able to identify those patients which need to be managed surgically from all others.