Patients with Small Renal Masses Undergoing Active Surveillance-Is Yearly Chest Imaging Necessary?

Abstract

INTRODUCTION AND OBJECTIVES:Active surveillance (AS) is recognized as a standard for the management of small renal masses (SRM). Renal cell carcinoma (RCC) can metastasize to the lungs, so yearly chest imaging has been indicated for the follow-up of patients with SRM on AS. However, given the low rates of metastasis from SRM and the potentially increased rates of incidental non-RCC related findings, the necessity of this yearly chest imaging comes into question.METHODS:We performed a retrospective analysis of 268 patients with SRM enrolled in the AS arm of the Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry at our institution. Chest imaging reports were examined to identify patients with abnormal findings, which were then determined to be actionable or non-actionable based on receipt of further clinical investigations/interventions.RESULTS:Of the 268 patients, 51 (19%) were found to have abnormal baseline chest images; of these 51 images, 22 (43%) were actionable or eventual...