Introduction

1. No. 182 Active surveillance for small renal masses: Outcomes within an Australian outpatient setting Dr Gideon A Blecher, Dr Sam S Farah, Prof Mark Frydenberg Department of Urology, Southern Health. Melbourne. Australia Posters Proudly Supported by: Introduction Small renal masses (SRMs) are frequently encountered due to the increasing utilisation of abdominal imaging. The rate of metastases is low and a minority will be benign. Active surveillance (AS) has therefore emerged as a potential management option. • Results • 45 patients presented between August 2004 and March 2010 underwent AS for a SRM • Mean patient age: 67 • 40 incidental, 5 haematuria • Average maximal diameter of 24mm • Intervention • 16 (36%) patients underwent further management • Mean age of patients undergoing intervention: 66 • Intervention included nephrectomy (3), partial nephrectomy (9), and radiofrequency ablation (4).  • Reasons: • had diagnostic biopsy (3) • growth (2), (17mm over 6 month, 3mm over 3 month) • lesion became enhancing (2) • patient choice (1) • not clearly stated (8) • Biopsy • 7 biopsies (15.6% of patients), following mean 8 months of AS • 6 RCC, 1 non-diagnostic • Pathology Outcomes: all negative margins, T1 • 6 Clear Cell RCC • 2 Papillary RCC • 2 Oncocytoma • 1 AML • 1 Leiomyoma • Growth Rates • SRM grew on average 3.5mm per year • Duration of Active Surveillance/NED • Mean 22 month duration (2-90) AS. 32 patients had >6month AS. • 7 patients have had post interventional follow up available. The mean duration of follow up subsequent to intervention is 18 months (5-37). No patients have developed metastatic disease or died from SRM. • Aim • To ascertain: • the growth rate of SRMs • the rate and reasons of cessation of surveillance • the rate of metastases and death from SRM • undergoing AS Methods A retrospective case series of all patients presenting with SRM to an outpatient Urological practice were reviewed. Inclusion criteria: Patients with a SRM, initial size less than 4cm Exclusion criteria: Lesions of initial size > 4cm, hyperdense cyst. Conclusions AS appears to be a safe method of managing patients with SRM. A minority of those undergoing AS will require further investigation (ie: biopsy) or definitive management as a result of growth or patient choice. References Rising incidence of renal cell cancer in the United States.Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. JAMA. 1999 May 5; 281(17):1628-31. Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DY, Uzzo RG. The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol. 2006 Feb;175(2):425-31. Acknowledgements Thank you to Mr M.Chong for providing some of the initial data