Treating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is SBRT the New Kid on the Block?

Jeffrey TuanSingapore Speaker Treating SRM in a 65-Year-Old ECOG 1 with Multiple Previous Operations-Is SBRT the New Kid on the Block?The management of small renal masses (SRMs) in older adults with prior surgical histories remains complex, particularly in patients with limited physiological reserve and increased perioperative risk. We present the case of a 65-year-old patient with an ECOG performance status of 1 and multiple prior abdominal surgeries, highlighting the challenges of repeated surgical intervention and the evolving role of stereotactic body radiotherapy (SBRT) as a non-invasive alternative. SBRT offers ablative doses of radiation with sub-millimeter precision, enabling tumor control while preserving renal function and minimizing treatment-related morbidity. Emerging data support its safety and efficacy in medically inoperable patients or those at high surgical risk. This case underscores the need to reconsider SBRT as a frontline therapeutic option in selected patients with SRM, particularly when traditional surgical or ablative approaches are contraindicated or carry significant risk. Further prospective studies are warranted to define optimal patient selection and long-term outcomes