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Interview at EMUC 2014 with Prof. Maria Pilar Laguna, Amsterdam, The Netherlands

Role of focal treatments in management of small renal masses


Histology of small renal lesions is mandatory for proper management and in particular follow up after ablation. No randomized studies compare ablation to partial nephrectomy or active surveillance. Dosimetry in ablation of small renal lesions during cryotherapy seems better than during radiofrequency ablation. Laparoscopic ablation is a good option for anterior lesions in the kidney with close proximity to the bowel but air and fluid interposition may be helpful and even simply repositioning the patient may allow percutaneous ablation in lesions found to be in close proximity to bowel. Downsizing of renal masses by tyrosine kinase inhibitors is around 20% and in most cases too low to clearly change management.