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Title: Harnessing the Genomic Landscape of the Small Renal Mass to Guide Clinical Management.
Austin Authors: Silagy, Andrew W;Sanchez, Alejandro;Manley, Brandon J;Bensalah, Karim;Bex, Axel;Karam, Jose A;Ljungberg, Börje;Shuch, Brian;Hakimi, A Ari
Affiliation: UCLA School of Medicine, Los Angeles, CA, USA
The Netherlands Cancer Institute, Amsterdam, The Netherlands
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Moffitt Cancer Center Genitourinary Oncology and Integrated Mathematical Oncology, Tampa, FL, USA
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Royal Free London NHS Foundation Trust and UCL Division of Surgery and Interventional Science, London, UK
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
Department of Urology, University of Rennes, Rennes, France
Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Issue Date: Nov-2019
Date: 2019-04-27
Publication information: European Urology Focus 2019; 5(6): 949-957
Abstract: Small renal masses (SRMs; tumors <4 cm) encompass a diagnostic and therapeutic challenge. Genomic profiling has the potential to improve risk stratification and personalize treatment selection. Herein, we review the evidence regarding the utility, challenges, and potential implications of genomic profiling in the management of SRMs. Pertinent publications available on PubMed database pertaining to kidney cancer, tumor size, genomics, and clinical management were reviewed. Compared with larger tumors, SRMs range from benign to lethal, necessitating strategies for improved treatment selection. Recent advances in the molecular characterization of renal cell carcinoma have improved our understanding of the disease; however, utility of these tools for the management of SRMs is less clear. While intratumoral heterogeneity (ITH) reduces the accuracy and reliability of sequencing, relative genomic uniformity of SRMs somewhat lessens the impact of ITH. Therefore, renal mass biopsy of SRMs represents an appealing opportunity to evaluate how incorporation of molecular profiles may improve management strategies. Ongoing research into the genomic landscape of SRMs has advanced our understanding of the spectrum of disease aggressiveness and may hold promise in matching disease biology to treatment intensity. Small renal masses are a clinical challenge, as they range from benign to lethal. Genomic profiling may eventually improve treatment selection, but more research is needed.
DOI: 10.1016/j.euf.2019.04.011
Journal: European urology focus
PubMed URL: 31040082
Type: Journal Article
Subjects: Biopsy
Kidney cancer
Renal cell carcinoma
Small renal mass
Appears in Collections:Journal articles

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