Top

Published in:

01-10-2018 | Original Article

Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study)

Authors: François-Xavier Nouhaud, Jean-Christophe Bernhard, Pierre Bigot, Zine-Eddine Khene, François Audenet, Herve Lang, Sebastien Bergerat, Guillaume Fraisse, Nicolas Grenier, François Cornelis, Cosmina Nedelcu, Sofiane Béjar, Gaëlle Fromont-Hankard, Yves Allory, Véronique Lindner, Virginie Verkarre, Laurent Daniel, Mokrane Yacoub, Jean-Michel Correas, Arnaud Méjean, Nathalie Rioux-Leclercq, Karim Bensalah

Published in: World Journal of Urology | Issue 10/2018

Abstract

Purpose

To evaluate and compare pathological characteristics of renal cysts Bosniak IIF, III and IV in light of recent histological classification.

Patients and methods

The French research network for kidney cancer UroCCR conducted a multicentre study on patients treated surgically for a renal cyst between 2007 and 2016. Independent radiological and centralized pathological reviews were performed for every patient. Pathological characteristics were compared to the Bosniak classification.

Results

Of a total 216 patients included, 175 (81.0%) tumours (90.9% of Bosniak IV, 69.8% of Bosniak III) were malignant or had a low malignant potential, with 60% of clear cell renal cell carcinoma (CCRCC), 24% of papillary RCC (PRCC) and 6.9% of multilocular cystic renal tumour of low malignant potential (MCRTLMP). Malignancies were mostly of low pT stage (86.4% of pT1–2), and low ISUP grade (68.0% of 1–2). Bosniak III cysts had a lower rate of CCRCC (46.7 vs. 67.3%), higher rate of PRCC (30 vs. 20.9%) and MCRTLMP (18.3 vs. 0.9%) compared to Bosniak IV (p < 0.001). Low-malignant potential lesions were less likely Bosniak IV and pT3–4 stage was more frequent in Bosniak IV vs. III (15.7 vs. 3.5%; p = 0.04). There were two recurrences (1.1%) and no cancer-related death occurred during follow-up.

Conclusion

These results confirmed that cystic renal malignancies have excellent prognosis. Bosniak III cysts had a low malignant potential, which suggests surveillance could be an option for these lesions.

Ljungberg B, Campbell SC, Choi HY et al (2011) The epidemiology of renal cell carcinoma. Eur Urol 60:615–621CrossRef

Ascenti G, Mazziotti S, Zimbaro G et al (2007) Complex cystic renal masses: characterization with contrast-enhanced US. Radiology 243:158–165CrossRef

Warren KS, McFarlane J (2005) The Bosniak classification of renal cystic masses. BJU Int 95:939–942CrossRef

Bosniak MA (1986) The current radiological approach to renal cysts. Radiology 158:1–10CrossRef

Israel GM, Bosniak MA (2005) An update of the Bosniak renal cyst classification system. Urology 66:484–488CrossRef

Ljungberg B, Bensalah K, Bex A et al (2015) EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 67(5):913–924CrossRef

Schoots IG, Zaccai K, Hunink MG et al (2017) Bosniak classification for complex renal cysts reevaluated: a systematic review. J Urol 198:12–21CrossRef

Bielsa O, Lloreta J, Gelabert-Mas A (1998) Cystic renal cell carcinoma: pathological features, survival and implications for treatment. Br J Urol 82:16–20CrossRef

Bensalah K, Albiges L, Bernhard J-C et al (2016) CCAFU french national guidelines 2016–2018 on renal cancer. Prog Urol. 27(Suppl 1):S27–S51CrossRef

10.

Moch H, Cubilla AL, Humphrey PA et al (2016) The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours. Eur Urol 70:93–105CrossRef

11.

Li T, Chen J, Jiang Y et al (2016) Multilocular cystic renal cell neoplasm of low malignant potential: a series of 76 cases. Clin. Genitourin. Cancer 14:e553–e557CrossRef

12.

Aydin H, Chen L, Cheng L et al (2010) Clear cell tubulopapillary renal cell carcinoma: a study of 36 distinctive low-grade epithelial tumors of the kidney. Am J Surg Pathol 34:1608–1621PubMed

13.

Tran T, Jones CL, Williamson SR et al (2016) Tubulocystic renal cell carcinoma is an entity that is immunohistochemically and genetically distinct from papillary renal cell carcinoma. Histopathology 68:850–857CrossRef

14.

Diolombi ML, Cheng L, Argani P et al (2015) Do clear cell papillary renal cell carcinomas have malignant potential? Am J Surg Pathol 39:1621–1634CrossRef

15.

Sevcenco S, Spick C, Helbich TH et al (2016) Malignancy rates and diagnostic performance of the Bosniak classification for the diagnosis of cystic renal lesions in computed tomography - a systematic review and meta-analysis. Eur Radiol 27(6):2239–2247CrossRef

16.

Hélénon O, Delavaud C, Dbjay J et al (2017) A practical approach to indeterminate and cystic renal masses. Semin Ultrasound CT MR 38:10–27CrossRef

17.

Bosniak MA (1997) The use of the Bosniak classification system for renal cysts and cystic tumors. J Urol 157:1852–1853CrossRef

18.

Kutikov A, Uzzo RG (2009) The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol 182:844–853CrossRef

19.

Patard J-J, Leray E, Rioux-Leclercq N et al (2005) Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 23:2763–2771CrossRef

20.

Reese AC, Johnson PT, Gorin MA et al (2014) Pathological characteristics and radiographic correlates of complex renal cysts. Urol Oncol Semin Orig Investig. 32:1010–1016CrossRef

21.

Beck SDW, Patel MI, Snyder ME et al (2004) Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma. Ann Surg Oncol 11:71–77CrossRef

22.

Teloken PE, Thompson RH, Tickoo SK et al (2009) Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. J Urol 182:2132–2136CrossRef

23.

Leibovich BC, Lohse CM, Crispen PL et al (2010) Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urol 183:1309–1315CrossRef

24.

Chandrasekar T, Ahmad AE, Fadaak K, et al. (2017) Natural history of complex renal cysts: clinical evidence supporting active surveillance. J Urol. https://doi.org/10.1016/j.juro.2017.09.078 CrossRef

25.

Smith AD, Allen BC, Sanyal R et al (2015) Outcomes and complications related to the management of Bosniak cystic renal lesions. AJR Am J Roentgenol 204:550–556CrossRef

Title: Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study)
Authors: François-Xavier Nouhaud
Jean-Christophe Bernhard
Pierre Bigot
Zine-Eddine Khene
François Audenet
Herve Lang
Sebastien Bergerat
Guillaume Fraisse
Nicolas Grenier
François Cornelis
Cosmina Nedelcu
Sofiane Béjar
Gaëlle Fromont-Hankard
Yves Allory
Véronique Lindner
Virginie Verkarre
Laurent Daniel
Mokrane Yacoub
Jean-Michel Correas
Arnaud Méjean
Nathalie Rioux-Leclercq
Karim Bensalah
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 10/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2307-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study)

Abstract

Purpose

Patients and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2018

Urologic Management of the Spinal Cord Injured Patient

Oncological safety and quality of life in men undergoing simultaneous transurethral resection of bladder tumor and prostate: results from a randomized controlled trial

Special considerations in the urological management of the older spinal cord injury patient

Surveillance and management of urologic complications after spinal cord injury

Early urological care of patients with spinal cord injury

Randomized clinical trial between polyacrylate-polyalcohol copolymer (PPC) and dextranomer-hyaluronic acid copolymer (Dx/HA) as bulking agents for endoscopic treatment of primary vesicoureteral reflux (VUR)