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Small incidental renal tumors are found commonly when older people undergo abdominal imaging. Although most such tumors are malignant histologically, they often grow slowly and do not cause symptoms.
To determine whether observation without intervention is reasonable for such patients, Cleveland Clinic researchers reviewed the cases of 537 patients with localized renal tumors (size, ≤7 cm) that were detected when patients were older (age, ≥75). Eighty percent of patients underwent surgery or ablative procedures (radiofrequency ablation [RFA] or cryoablation), and 20% were observed without intervention. During median follow-up of 4 years, 148 patients died, but only 6 deaths were secondary to renal cell carcinoma. Observation patients were ol…