When it comes to small kidney tumors (less than 4 cm in size), discernment is everything. “As many as 30 percent of all small renal masses are benign,” says Nirmish Singla, M.D., M.Sc. Director of the Kidney Cancer Program. “And among the ones that are cancerous, the vast majority either remain stable or grow very slowly and can be managed safely with active surveillance,” which includes regular follow-up imaging. 

Much of what doctors know about the natural history of these tumors over time comes from data collected in the multi-institutional Delayed Intervention and Surveillance for Small Renal Masses (DISSRM) registry, which was founded at the Brady in 2009. 

In a recent study led by Singla, Brady investigators have shed even more light on which tumors may be likely to need treatment: “We analyzed the DISSRM registry and found that larger tumor size, particularly above 2.9 cm, was associated with increased growth rate and conversion to delayed intervention for small renal masses,” Singla says. “The ability to predict how these tumors will behave over time, and which tumors are likely to grow more quickly, gives us valuable information for joint decision-making with our patients in situations where there may not be a right or wrong answer.” This work was published in the British Journal of Urology International. 

Singla and colleagues also recently published the mature outcomes from the entire DISSRM registry, which includes over 950 enrolled patients, in the Journal of Urology. “We are proud that these data provide continued, longitudinal support for active surveillance as an appropriate strategy for small renal masses.”