title: Clinical outcome of incidentally discovered small renal cell carcinoma after delayed surgery.
abstract: BACKGROUND
  This study was undertaken to investigate the growth rate and clinical outcome of patients with a small renal mass (SRM) after delayed surgery.
  
  
  METHODS
  We reviewed the clinical records of 34 patients with SRMs ≤ 4 cm at diagnosis, who underwent delayed surgical intervention during surveillance from January 2000 to December 2011. Radiographic evaluations using computed tomography (CT) scan and magnetic resonance imaging (MRI) were performed at least every 6 months, and the tumor size was determined at least twice.
  
  
  RESULTS
  The mean follow-up time was 26.6 ± 18.6 months and mean tumor doubling time was 23.4 ± 16.0 months. Histopathological analysis revealed that 32 of the 34 patients were malignant in pT1aN0M0. Only one patient showed tumor recurrence, who subsequently died due to tumor progression.
  
  
  CONCLUSIONS
  The growth rate of the small renal mass was slow in the majority of our patients. Delayed intervention does not have a detrimental effect on cancer-specific outcomes.
authors.affiliation: Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan ; Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Oki
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nose
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nishioka
authors.forename: Shogo
authors.initials: S
authors.lastname: Adomi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ohzeki
authors.forename: Atsunobu
authors.initials: A
authors.lastname: Esa
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
keywords: delayed intervention; growth rate; natural history; renal cell carcinoma; small renal mass