Understanding Criteria for Surveillance of Patients With a Small Renal Mass

Objective To better delineate which factors influence the decision to undergo active surveillance of small renal masses. Methods We identified 204 consecutive patients at our institution with clinical Stage T1 renal masses from June 2009 through June 2010. A variety of demographic and clinical characteristics were measured. Based on our previous work, the “ideal” criteria for active surveillance included tumor size ≤4 cm, Charlson comorbidity index of ≥2, Eastern Cooperative Oncology Group (ECOG) performance status (PS) of ≥2, and estimated glomerular filtration rate 60 miles ( P = .04), ECOG PS of ≥2 ( P < .01), tumor size ( P < .01), multifocality ( P = .03), endophytic nature of lesion ( P = .04), and whether the patient's surgeon generally used a robotic, laparoscopic, or open approach ( P = .01). Neither the baseline estimated glomerular filtration rate ( P = .91) nor the Charlson comorbidity index ( P = .69) were significant factors. The combination of tumor size