Contemporary Management of Small Renal Masses by Urologic Oncologists: A 2022 Korean Renal Cancer Study Group Practice Pattern Survey

Abstract

Purpose: Increased abdominal imaging brought about an explosive increase in the incidental detection of small renal masses (SRMs). In the absence of optimal guidelines for health screening, as well as subsequent diagnostic and therapeutic action plans, incidentally detected SRMs may likewise increasingly become a dilemma, especially in an aging society. In the current study, we aimed to describe the current practice patterns for incidentally detected SRMs among urologic oncologists and to identify key indicators in action plans for active surveillance. Materials and Methods: A survey containing 18 questions on SRM management patterns was designed. In June 2022, an online survey was sent to all 711 active members of the Korean Urological Oncology Society via email. After response collection, a consensus meeting of the Korean Renal Cancer Study Group, which 19 specialists attended, was held to analyze the results. Results: In total, 176 responses from participants practicing in an academic setting were obtained (24.8%, 176 of 711). Regarding the age of patients with SRMs, 42.6% (n=72) responded that they would recommend diagnostic evaluation and definitive treatment for anyone under 80 years of age as long as the patient was healthy. The most commonly used target indicators for surveillance termination were a tumor growth rate above a certain velocity (57.9%, n=102) and size increase above a certain diameter (36.9%, n=65). Renal mass biopsy was recommended in very select cases (<10% of all patients) by most respondents (53.4%, n=94), followed by “not using it at all” in 25.6% (n=45). Conclusions: We described the current practice patterns for incidentally detected SRMs among urologic oncologists and identified key indicators in action plans for active surveillance. This survey provided robust information, empowering physicians with a detailed knowledge of practice patterns and valuable insights on SRMs.