DISCOVERY IN KIDNEY CANCER
Active Surveillance for Small Kidney Tumors
“Early data indicate that patients undergoing active surveillance have similarly excellent cancer survival rates when compared to patients undergoing immediate surgery.”
With kidney tumors, size matters: many tumors that are smaller than four centimeters are either benign or slow-growing cancers that may never need to be treated. Active surveillance is helping many people with these small tumors avoid unnecessary surgery. In 2009, urologist Phillip Pierorazio, M.D., started the DISSRM (Delayed Intervention and Surveillance for Small Renal Masses) Registry, a large, prospective trial that follows more than 600 people with small renal masses, and is its principle investigator. “Early data from the registry indicate that patients undergoing active surveillance have similarly excellent cancer survival rates when compared to patients undergoing immediate surgery,” he says. These data were published in European Urology in 2015.
As part of the DISSRM Registry, patients regularly answer quality-of-life questionnaires; new data, recently published in the Journal of Urology, indicates that quality of life for these patients is not adversely affected by active surveillance. Patients choosing active surveillance tend to be older and to have other medical issues beside the small kidney tumor. Over time, quality of life improved, both for those who underwent surgery and those who remained on active surveillance, and was driven by improvements in perceptions of mental wellbeing. “It is very reassuring that our DISSRM program alleviates anxieties and makes people feel safe while under our care,” says Pierorazio.