Active Surveillance Is Effective for Small Renal Masses in Patients With ESRD

Active surveillance (AS) appears effective in renal transplant candidates and immunocompromised patients with small renal mass (SRM), according to a study presented at the 2022 International Kidney Cancer Symposium: North America.

In this study, Zoe S. Gan, MD, and colleagues used the multi-institutional Delayed Intervention and Surveillance for Small Renal Masses prospective registry to assess patients with SRMs and end-stage renal disease (ESRD) or immunocompromised status. In the population of interest, the following variables were extracted: follow-up period, mass size at diagnosis, mass growth rate, development of metastases, and timing and type of intervention, if applicable.

The researchers observed the average size of the SRM at diagnosis was 2.3 cm, and over a mean follow-up period of 2.4 years, the mean SRM growth rate was 0.1 cm/year. A total of 40% of patients underwent either intermediate (n=4) or delayed intervention (n=2). According to the results, of the 60% of patients remaining on surveillance, none developed metastases. Of the 44 immunosuppressed patients, the mean size of the SRM at initial diagnosis was 1.9 cm, and over a mean follow-up period of 3.5 years, the mean SRM growth rate was 0.2 cm/year. In this population, 32% of patients underwent either immediate (n=9) or delayed intervention. Of the 68% of patients remaining on surveillance, none developed metastases, the researchers noted.

“Limited prospective data suggest that ESRD and immunosuppressed patients on AS for SRMs have similar short-term outcomes to those of immunocompetent controls with SRMs of the same size, suggesting promise for the safety of AS in renal transplant recipient candidates,” the researchers concluded.

Source: Gan Z, Besharatian B, Naji A, Pierorazio P. Short-term outcomes of active surveillance for small renal masses in patients with end-stage renal disease and immunosuppression. Poster 21. Presented at the 2022 IKCS: North America; November 4-5, 2022; Austin, Texas.