IJU this issue

Abstract

Thank you for reading IJU this issue. This issue contains one Review Article, 12 Original Articles and one Urological Notes – it is rich in variety. The Review Article was written by Borghesi et al. (Bologna, Italy) on active surveillance for localized renal tumors. Recently, the widespread use of abdominal imaging has led to an increasing detection of small renal masses, and approximately 20–30% of those tumors will prove to be benign, with low metastatic potential if not immediately treated. This article reviews active surveillance as a safe and reasonable option for patients with renal tumors <4 cm (cT1a) and short life expectancy, according to the current available evidence. Few studies with short-term follow up reported the preliminary results of active surveillance, even in cT1b–cT2 tumors. With acceptable risk of disease progression and mortality, this approach should be considered in this setting only for highly selected and well-informed patients. Furthermore, surveillance protocols can be proposed in selected patients with uncomplicated benign tumors, such as angiomyolipoma, in which active surveillance should be considered the initial standard management. At present, reliable clinical predictors of a tumor's growth rate and aggressiveness are not available. Renal tumor biopsy is useful in the clinical work-up of patients who are candidates for active surveillance, in order to improve patient selection based on tumor histological characterization. Despite the proof of safety offered by expectant management for small renal masses in selected patients, further prospective studies with longer follow up are required in order to confirm the indications and long-term oncological outcomes of active surveillance protocols for renal tumors. One of the Original Articles was written by Isotani et al. (Tokyo, Japan) on computational robot-assisted partial nephrectomy planning by virtual partial nephrectomy analysis. This manuscript presented a novel system that allows the surgeon to better inform decision-making both pre- and intraoperatively for patients undergoing partial nephrectomy. The system was considered with three principal aims: (i) to inform the previously subjective decision-making process of whether or not to attempt selective clamping; (ii) to enucleate, and the respective risk of collecting system opening; and (iii) to offer the surgeon an approximation of a patient's renal function post-resection, based on the ratio of post- to preoperative renal cortical volume. Finally, this issue has several Editorial Comments. Nine Original Articles (75% of all) have at least one Editorial Comment. Editorial Comments are very useful for writing manuscripts, and interesting how to think about manuscript for reviewers. Please enjoy the combination of Original Articles and Editorial Comments. None declared.