Predicting biological behaviour of newly diagnosed renal masses: a possible role of cell proliferation biomarkers?

Due to the common use of axial imaging, a surge in renal cell carcinoma (RCC) incidence has been observed in the last decades, with cT1 tumors accounting for 40–50% of new diagnosis (1). Despite earlier detection, mortality remained stable, suggesting possible overdiagnosis and overtreatment (2). Actually, one out of three small renal masses (SRMs) are benign and most of the malignant ones (80%) are low-grade tumors, with a 5-year cancer specific survival (CSS) of 95–100% (2,3). Given these characteristics, lesions traditionally treated with surgery are increasingly managed with nephron sparing approaches (4).