Introduction to small renal tumours and prognostic indicators
Overview
Kidney cancer is among the third
most common urologic malignancy and it indicates around 4 percent of the total
malignancies in the US along. As pre reports, in 2010, 58,000 new cases
pertaining to renal cell carcinoma were diagnosed and it has witnessed around
13,000 deaths. And the same report suggests that there is an increment of 2-4
percent of deaths witnessed due to these issues. Most of the cases are reported
with small size tumors; hence one can find the stage migration over the
incident cases of the renal cancerous tumor. But you can find lesions
representing booth the benign and malignant tumors. The terminology called
small renal mass can be introduced for all the small size tumors and the small
renal masses are seen having defined over enhancing tumor that are less than
the 4 centimeter diameter.
Understanding the renal tumours and prognostic indicators
If you find a small renal mass to
be the RCC, it falls under the TNM category. Such kind of masses are seen with
having one of the best prognosis with treatment, hence it not at all
astonishing that despite the early diagnosis & treatment, the overall RCC
specific mortality is reports and is certainly not seen decreasing in the
recent years. In the current age, you can find pretreatment pathologic confirmation
of the RCC that needs a core needle biopsy. Traditionally this biopsy is not
often considered due to safety concerns and tumor accuracy and seeding.
Importantly, the whole notion that biopsy simply results often change the
management plans that end up reducing its utility, however, as the pathologic
assessment are seen improving, this idea emerges as an important challenge for
many.
Imaging Characteristics of small
size renal masses
The diagnosis test options like
CT is considered to be the primary imaging option, which is use di the
characterization of renal masses, however, the option of ultrasound remains to
be very much useful. With the ultrasound to be among the most common diagnostic
method and could pose challenge to the diagnosis process of RCC. The
sensitivity of the tests like ultrasound would reduce with the increasing size
of tumor like that at one cm, the test is able to identity by 20 percent of
masses as compared with the 76 percent identified by CT scan. The sensitivity
of ultrasound would however enhance to 70 percent for tumors of 2 cm. The retroperitoneum
and renal vasculature assessment of RCC seems to be very much limited, which is
really vital in terms of tumor staging.Both the expert opinion and published
guidelines thus would be seen supporting the use of cross-sectional imaging
with techniques like CT scan or MRI in the workup of the renal tumor.
Current Renal Treatment Methods
and Results
The procedures like Radical Nephrectomy can be effective against the cancer specific cases; however, it is
still regarded as technically unfavorable lesions in certain ways including the
location and comorbidity point of view. The next treatment option like partial
nephrectomy is also considered to be a standard option for the treatment option
of small renal masses. Some experts claim that the desirable surgical margin of
around half of cm can be seen with oncologist safety of any negative margin
regardless of the size. Patients considering procedures like radical
nephrectomy are often seen closer to the risk side of the chronic renal
insufficiency than are very similar kinds of patients undergoing the procedure partial
nephrectomy, with equivalent oncologic results. Lastly with the minimally
invasive procedures the patients with renal tumors are able to get much better
outcomes as compared to the other surgical procedures for obvious reasons.
These reasons are backed with good amount of benefits that makes it to be the
most preferred choice by both the patients and surgeons.
