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University of Montreal Health Center, Montreal, QC, Canada.
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Editor’s note: Data from the National Cancer Institute SEER (Surveillance, Epidemiology and End Results) registry demonstrate an increased incidence of small renal masses (i.e. ≤4 cm) between the years of 1983 and 2002. The standard of care for such tumors is partial or radical nephrectomy; however, non-surgical management (NSM) is also an acceptable management strategy. NSM includes, among other strategies, surveillance of patients, where close observation over 12 months leads to surgery only in patients who have had tumor growth. However, there are currently no results from population-based studies to support this approach. In this study, cancer-specific and other-cause mortality after NSM or nephrectomy in patients with small renal masses was analyzed to compare these treatment modalities.