Pd06-08 Kidney Watch: Navigating Incidental Small Renal Mass Surveillance in Kidney Transplant Recipients

You have accessJournal of UrologyTransplantation & Vascular Surgery I (PD06)1 May 2024PD06-08 KIDNEY WATCH: NAVIGATING INCIDENTAL SMALL RENAL MASS SURVEILLANCE IN KIDNEY TRANSPLANT RECIPIENTS Ricardo Sánchez-Méndez, Grace Maline, Shavy Nagpal, Nicole Ali, Anthony Corcoran, Katie Murray, and William C. Huang Ricardo Sánchez-MéndezRicardo Sánchez-Méndez , Grace MalineGrace Maline , Shavy NagpalShavy Nagpal , Nicole AliNicole Ali , Anthony CorcoranAnthony Corcoran , Katie MurrayKatie Murray , and William C. HuangWilliam C. Huang View All Author Informationhttps://doi.org/10.1097/01.JU.0001008592.06852.43.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radiographic transplant work-up imaging often reveals many incidental findings including small renal masses (SRMs) of<4 cm. While active surveillance (AS) can be a safe approach in the general population, treatment of the mass is often preferred for patients needing long term immunosuppression. We examined the contemporary experience with the diagnosis and management of SRMs in kidney transplant (KT) candidates at a single tertiary referral center. METHODS: Using a retrospectively maintained KT candidate database, we identified patients with pre-KT urology referrals and abdominal imaging revealing incidental SRMs during their transplant evaluation. We then evaluated patient demographic, radiographic, and operative data through retrospective chart review of patients with an identified SRM. We also calculated growth rates of those on AS and pathological features for those undergoing surgical extirpation. RESULTS: Of 3,402 KT patients between 1/2016 to 8/2023, 59 had an incidental SRM and urology referral. The median maximal diameter was 2.3 cm and 22.0% (n=13) were multifocal. At a median 55.5 months since mass identification, 41/59 (69.5%) had undergone KT. Of those 41, 53.7% (n=22) were managed with AS, while 46.3% (n=19) were managed with native nephrectomy. The majority of excised SRMs were of indolent behavior and early pathologic stage, and the predominant histologic subtypes were papillary and clear cell papillary (Table 2). At a median follow-up of 16.4 months from the KT date, no subjects in AS had undergone post-KT native nephrectomy, and only 1 AS subject showed a tumor growth rate of >5 mm/yr. CONCLUSIONS: Our data suggests that SRMs managed with AS in KT candidates rarely exhibit aggressive post-KT growth rates. While active treatment remains a preferred management strategy, patients who cannot undergo surgery or have limited SRM characterization may be followed with AS with favorable outcomes. Further research is needed to evaluate long-term cancer outcomes in this population and expand to other solid organ transplant recipients. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e163 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ricardo Sánchez-Méndez More articles by this author Grace Maline More articles by this author Shavy Nagpal More articles by this author Nicole Ali More articles by this author Anthony Corcoran More articles by this author Katie Murray More articles by this author William C. Huang More articles by this author Expand All Advertisement PDF downloadLoading ...