Patients with large renal tumors require immediate treatment, according to German researchers.

Investigators at the University of Munich identified nine patients with solitary large renal masses (greater than 4 cm in diameter) who had abdominal imaging with identification of renal masses more than six months before hospital admission. In no case did the initial imaging lead to admission.

The median follow-up from initial diagnosis to surgery was 14.6 months. The median observed tumor growth rate was 6.41 cm/year, much higher than the growth rate of small renal masses, which is assumed to be 0.1-0.7 cm/year, according to a report in BJU International (2010;105:928-931).

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The researchers concluded that tumors 4 cm in diameter or larger are not candidates for active surveillance.