title: Treatment of cT1a Renal Tumours in Germany: A Nationwide Survey.
abstract: OBJECTIVE
  To identify clinical parameters influencing German urologists treating cT1a renal tumours, we performed a nationwide survey among members of the German urological associations (DGU and BDU).
  
  
  METHODS
  In spring 2012, DGU and BDU members were invited to complete our survey. For 8 cases and 3 index patients, participants were asked about their preferred treatment. Multivariate analyses were used to identify significant parameters leading the responders to favour radical nephrectomy (RN) over nephron sparing surgery (NSS) as well as active surveillance (AS) over invasive treatment.
  
  
  RESULTS
  Three hundred six (7.4%) forms were included in our analysis. In patients with larger tumours (4 vs. 2 cm, OR 3.16), endophytic growth (endophytic vs. exophytic, OR 2.70), hilar tumour location (perihilar vs. polar, OR 14.37), normal renal function (normal vs. decreased, OR 1.92) and elderly patients (elderly vs. young, OR 2.14) RN was preferred. Based on decreased renal function (decreased vs. normal, OR 12.74), elderly (elderly vs. young, OR 14.31) and hilar tumour location (perihilar vs. polar, OR 2.14), 77.2% of respondents recommended AS for selected patients. Treating physician factors had no influence on the treatment preference.
  
  
  CONCLUSIONS
  Elderly patients with small tumours and impaired renal function were candidates for AS. Younger patients mainly underwent NSS. However, when the tumours' location was endophytic or hilar, RN was recommended.
authors.affiliation: Department of Urology and Pediatric Urology, University Medical Center, Johannes-Gutenberg-University, Mainz, Germany.
authors.forename: Sherif
authors.initials: S
authors.lastname: Mehralivand
authors.forename: Andreas
authors.initials: A
authors.lastname: Neisius
authors.forename: Christian
authors.initials: C
authors.lastname: Thomas
authors.forename: Christian
authors.initials: C
authors.lastname: Hampel
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Thüroff
authors.forename: Frederik C
authors.initials: FC
authors.lastname: Roos
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005858:Germany; D006801:Humans; D007668:Kidney / Q000601:surgery; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons / Q000601:surgery*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D014572:Urology / Q000379:methods*