Influence of tumor-associated factors on the treatment selection between partial nephrectomy and ablation therapy for small renal tumors (Review)

TL;DR

This review discusses factors influencing treatment choices for small kidney tumors, comparing surgery and ablation therapy.

Contribution

The paper provides a comprehensive review of tumor-associated factors impacting treatment decisions for small renal tumors.

Findings

Ablation therapy may offer better safety and functional outcomes compared to surgery.

Tumor location and patient condition significantly influence treatment selection.

Partial nephrectomy is preferred for tumors near major vessels but challenging for endophytic tumors.

Abstract

For small renal tumors, nephron-preserving treatment, including partial nephrectomy or ablation therapy, is recommended. According to major guidelines, ablation therapies are advised for patients who are deemed not suitable to undergo surgery due to an advanced age or the presence of comorbidities. However, compared with surgery, ablation therapy can result in superior safety and functional outcomes. The present review discusses the factors affecting decision-making as regards treatment options for small renal tumors. When determining an appropriate treatment option, tumor locations, as well as the condition and preferences of the patient, are considered. Scoring systems, such as the RENAL Nephrometry Score can assist in guiding treatment decisions. However, surgery may be the preferred approach for tumors near major vessels and collecting systems. For endophytic tumors, partial nephrectomy can be challenging due to the difficulty in visualizing intra-parenchymal tumors during the procedure, whereas ablation therapies may be inferior to partial nephrectomy. Although treatment selection for small renal tumors can be affected by tumor location, partial nephrectomy remains the gold standard for numerous cases.