title: Introduction to small renal tumours and prognostic indicators.
abstract: Over the past years, the widespread use of radiological imaging for evaluating abdominal symptoms unrelated to kidney cancer has been linked to a significant increase in the percentage of renal tumours incidentally detected at an asymptomatic stage. The definition of 'small' renal tumours has changed over the years. Presently, according to dimensional criteria, surgical indications and prognostic impact, small renal tumours are defined as masses ≤4 cm in size. Classical preoperative variables that influence the decision-making process in the management of T1a renal tumours can be classified as patient-related and tumour-related factors. Age is an independent predictor of cancer-specific survival (CSS), with older patients exhibiting significantly worse survival. An accurate classification of the anatomical and topographical characteristics of small renal masses based on available nephrometry systems is necessary for standard preoperative evaluation of patients eligible for partial nephrectomy (PN). Renal tumour biopsies (RTBs) can be indicated in patients eligible for active surveillance or ablative treatments, those with other primary tumours, those with prior renal lesions and/or those with multiple synchronous tumours, showing a median diagnostic rate of 92%. Small renal tumours typically have a good prognosis. Patient age, mode of presentation, nuclear grading, coagulative necrosis and histologic subtype can influence the prognosis of this subgroup of RCC.
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Urology Unit, Udine, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Crestani
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Urology Unit, Udine, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Rossanese
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Urology Unit, Udine, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Calandriello
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Pathology Unit, Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Sioletic
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Urology Unit, Udine, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Giannarini
authors.affiliation: Academic Medical Centre Hospital "Santa Maria della Misericordia", Urology Unit, Udine, Italy; Department of Experimental and Clinic Medical Sciences, Urology Unit, University of Udine, Italy. Electronic address: ficarra.vincenzo@aoud.sanita.fvg.it.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ficarra
mesh_terms: D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000066491:Clinical Decision-Making; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009392:Nephrectomy; D011379:Prognosis; D047368:Tumor Burden
keywords: Kidney cancer; Partial nephrectomy; Renal cancer; Small renal tumours