# Partial nephrectomy, ablation & active surveillance of small renal masses

Source: https://onco.cc/technologies/partial-nephrectomy-active-surveillance/  
OnCo record `partial-nephrectomy-active-surveillance` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Most small kidney tumours found on scans grow slowly. Options range from watching them, to freezing or heating them, to removing just the tumour and keeping the kidney.

## Summary

Small renal masses (<4 cm) are increasingly found incidentally; 20-30% are benign or indolent. Active surveillance (DISSRM, Canadian registry) shows low metastatic risk with growth-triggered intervention. Partial (nephron-sparing) nephrectomy, usually robotic, is preferred for T1 tumours; radical nephrectomy for larger or central tumours. Percutaneous cryoablation or microwave ablation for small tumours in comorbid patients; renal mass biopsy and SBRT (FASTRACK II) are expanding roles.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-07
- Principle: Nephron preservation reduces chronic kidney disease and cardiovascular mortality; surveillance exploits the slow natural history of most small masses.
- Strengths: Kidney function preserved; Avoids overtreatment of benign masses
- Limitations: No reliable imaging biomarker for aggressive small tumours; Surveillance anxiety and adherence

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Nephrectomy
- Wikipedia: https://en.wikipedia.org/wiki/Nephrectomy

## Connected records

- cancers: [Renal cell carcinoma](https://onco.cc/cancers/rcc/)
- fronts: [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- technologies: [Cryoablation systems](https://onco.cc/technologies/cryoablation-systems/), [Robotic & minimally invasive surgery](https://onco.cc/technologies/robotic-surgery/), [SBRT / SABR (stereotactic radiotherapy)](https://onco.cc/technologies/sbrt/), [Thermal ablation (RFA, microwave, cryo)](https://onco.cc/technologies/thermal-ablation/)
- bottlenecks: [Overdiagnosis and false alarms](https://onco.cc/bottlenecks/b-overdiagnosis/)
- terms: [Von Hippel-Lindau disease](https://onco.cc/terms/vhl-disease/)
- roadmaps: [Devices and physical therapies roadmap: heat and light → electric fields and focused sound → drug-releasing implants](https://onco.cc/roadmaps/devices-roadmap/), [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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