The American Society of Clinical Oncology has published a clinical practice guideline on management of small renal masses (SRM). Among the recommendations:

• All patients with an SRM should be considered for a biopsy when the results may alter management.
• Active surveillance should be an initial management option for patients who have significant comorbidities and limited life expectancy.
• Partial nephrectomy (PN) for SRMs is the standard treatment for whom an intervention is indicated.
• Percutaneous thermal ablation should be considered an option if complete ablation can reliably be achieved.
• Radical nephrectomy for SRMs should only be reserved for patients who possess a tumor of significant complexity that is not amenable to PN or for whom PN may result in unacceptable morbidity.
• Referral to a nephrologist should be considered if chronic kidney disease or progressive chronic kidney disease occurs after treatment, especially if associated with proteinuria.