title: Clinical Outcome of Small Renal Cell Carcinoma after Delayed Surgery versus Immediate 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 versus immediate surgery.
  
  
  METHODS
  We reviewed the clinical records of 328 patients with SRM ≦ 4cm at diagnosis, who underwent delayed or immediate surgical intervention from January 2000 to December 2011. Radiographic evaluation using CT scan and MRI were performed at least every 6 months and the tumor size was determined at least twice in the delayed surgery group.
  
  
  RESULTS
  A total of 292 RCC patients with pT1aN0M0 were identified; among them, 32 patients had been managed with delayed surgery intervention. No statistically significant difference was observed in overall survival rate (OSR) and cancer recurrence-free rate (CRFR). But cancer-specific survival rate (CSSR) was significantly lower in the delayed surgery group (p=0.0002).
  
  
  CONCLUSIONS
  The overall survival rate of delayed surgery was not inferior compared with that after immediate surgery. Delayed surgery intervention for SRMs is a treatment option in the current study.
authors.affiliation: 1. Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; ; 2. 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: Kazuhiro
authors.initials: K
authors.lastname: Nose
authors.forename: Hideo
authors.initials: H
authors.lastname: Tahara
authors.forename: Masaaki
authors.initials: M
authors.lastname: Imanishi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nishioka
authors.forename: Atsunobu
authors.initials: A
authors.lastname: Esa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kajikawa
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
keywords: delayed surgery; immediate surgery; natural history.; renal cell carcinoma; small renal mass
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