title: Current practice patterns in the surgical management of renal cancer in the United States.
abstract: Over the last two decades, there has been a rising incidence of renal tumors, particularly, small renal masses (<4 cm) resulting in a downward size and stage migration. This has brought about a paradigm shift in the management of newly diagnosed renal masses, such that nephron-sparing surgery, minimally invasive techniques, and active surveillance are frequently considered preferable to the historical gold standard of open radical nephrectomy. Population-based cohort studies indicate, however, that the widespread adoption of these techniques has been relatively slow and incomplete leading to significant disparities in the delivery of care throughout the country. Further investigation is required to determine the barriers to diffusion of new techniques and technology as well as to ensure equal access to quality care in the United States.
authors.affiliation: Department of Urology, NYU Langone Medical Center, 2nd Floor, 150 East 32nd Street, New York, NY 10016, USA.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Sivarajan
authors.forename: William C
authors.initials: WC
authors.lastname: Huang
mesh_terms: D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States