The management of incidentally discovered kidney tumors has changed recently because of improved understanding of their natural history and longer cancer-related survival. Usually found as incidental masses on diagnostic imaging, small kidney tumors are defined as lesions of 4 cm or smaller (American Joint Committee on Cancer stage T1a).1 There has been a 3-fold increase in their detection during the past several decades coincident with increases in imaging utilization.2 In the past, the conventional treatment for most kidney tumors was surgical resection, which mitigated risks of cancer progression but did not result in an overall survival benefit for small tumors.2 More recent evidence suggests that not all of these lesions should be resected because some are benign, and for some patients with small kidney cancers, there is a greater risk for mortality from nononcologic causes than from kidney cancer.
Kang SK, Bjurlin MA, Huang WC. Management of Small Kidney Tumors in 2019. JAMA. 2019;321(16):1622–1623. doi:10.1001/jama.2019.1672
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