Management of Small Renal Masses

Surgical excision of renal cell carcinoma is the current standard of care for localized disease. Series for small renal masses treated with surgery demonstrate excellent oncologic outcomes with 5-year survival rates over 95%. Minimally invasive ablative technologies, such as cryotherapy and radiofrequency ablation, have recently emerged with similar short- and intermediate-term results. Additionally, recent data on active surveillance have demonstrated survival rates comparable to surgery and ablation in selected patient populations. We review the currently available data regarding the management of small renal masses by excision, ablation, or observation.