Decision-Making in Small Renal Masses

EP: 1.The Evolvement of Imaging in ccRCC

EP: 2.The Biggest Challenges in Distinguishing ccRCC From Benign Renal Masses

EP: 3.Strengths and Weaknesses of Imaging Modalities in ccRCC

EP: 4.Treatment or Lack of Treatment of Small Renal Masses

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EP: 5.Decision-Making in Small Renal Masses

EP: 6.Current Unmet Needs in ccRCC Diagnosis

EP: 7.Early Detection of ccRCC

EP: 8.Key Benefits of PET in ccRCC Risk Stratification

EP: 9.The ZIRCON Trial

EP: 10.The MOA of TLX250

EP: 11.Top-Line Results of the Phase 3 ZIRCON Study

EP: 12.Risk Stratification in ccRCC: The Impact in Patient Populations

EP: 13.Lymph Node–Positive Kidney Disease: Future Implications of PET Imaging

EP: 14.Overcoming Challenges for Wider Adoption of TLX250

EP: 15.The Future of PET Imaging Agents

EP: 16.The Logistical Challenges in ccRCC Treatment

Clinical Utility of Renal Mass Biopsy

Main Discussion Topics:

• Biopsy may be more useful in patients with comorbidities where benign diagnosis would change management.
• Higher utility when nephron-sparing surgery is unlikely and nephrectomy would significantly impact renal function
• Patient preferences regarding surveillance vs intervention play an important role.
• Approximately 15% of radical nephrectomies for tumors that are 7 cm or larger were found to be oncocytoma or chromophobe renal cell carcinoma, where partial nephrectomy would have been appropriate.

Key Points for Physicians:

• Consider biopsy when management would change based on histology.
• Higher value in patients with impaired renal function or when radical nephrectomy is likely
• Biopsy can prevent unnecessary nephron loss in select cases.
• Patient-specific considerations should guide biopsy decisions.

Notable Insights:

Biopsy has particular value when nephron preservation is critical and when radical nephrectomy is likely based on tumor characteristics.

Clinical Significance:

Selective use of renal mass biopsy can prevent unnecessary nephron loss and guide appropriate therapy in challenging clinical scenarios.