Abstract
Treatment modalities for small renal masses (SRMs) include open or minimally invasive radical or partial nephrectomy, and laparoscopic or percutaneous ablations. Members of the Endourological Society were surveyed to evaluate how practitioner and clinical practice characteristics may be associated with the management of SRMs over time. The survey assessed characteristics of urologists (recency of residency and fellowship training, clinical practice type and location, and treatment modalities available) and their management of SRMs over the past year and over the course of the year 5 years prior. Of the 1495 surveys e-mailed, there were 129 respondents (8.6%). Comparing the past year to 5 years prior, there was increasing utilization of robotic partial nephrectomy (p < 0.001) and robotic radial nephrectomy (p = 0.031). In contrast, there was decreasing utilization of open partial nephrectomy (p < 0.001), open radical nephrectomy (p = 0.039), laparoscopic partial nephrectomy (p = 0.002), and laparoscopic radical nephrectomy (p = 0.041). Employment of laparoscopic ablation decreased (p = 0.001), but that of percutaneous ablation did not change significantly. For masses treated with image-guided therapy, there was increasing utilization of microwave ablation (p = 0.008) and decreasing usage of radiofrequency ablation (p = 0.002). Future studies should focus on the most effective treatment modalities based on provider, patient, and tumor characteristics.
Highlights
With increased utilization of CT scans, ultrasound, and other diagnostic imaging techniques, the incidental detection of renal masses has become progressively more common [1,2,3,4,5]
This study sought to describe the clinical, surgical, geographic and temporal factors that may relate to management strategies by members of the Endourological Society who practice in the United States
An electronic survey was designed to assess the characteristics of urologists, their clinical practices, and their management of small renal masses (SRMs) both in the past year and during the year 5 years prior
Summary
With increased utilization of CT scans, ultrasound, and other diagnostic imaging techniques, the incidental detection of renal masses has become progressively more common [1,2,3,4,5] Commensurate with this trend, the incidence of small renal masses (SRMs) has steadily grown by as much as 3.7% annually since the 1970s [2, 6, 7]. Trends in the management of small renal masses microwave, or radiofrequency ablation, and active surveillance [8]. Many of these treatment options involve newer technologies and have only recently become more widely utilized. This study sought to describe the clinical, surgical, geographic and temporal factors that may relate to management strategies by members of the Endourological Society who practice in the United States
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