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01-05-2018 | Original Article

Worth a second look: outcomes of patients with initial finding of regular renal tissue in CT-guided renal tumor biopsies

Authors: M. Sadat-Khonsari, M. Papayannis, P. Schriefer, L. Kluth, C. Meyer, V. Schüttfort, M. Regier, M. Rink, F. Chun, M. Fisch, A. Becker

Published in: World Journal of Urology | Issue 5/2018

Abstract

Introduction and objective

Renal tumor biopsy is recommended for histological diagnosis of radiologically indeterminate renal masses, to select patients with small-renal masses for surveillance approaches, before ablative treatments and to confirm metastatic spread of renal cell cancer (RCC), according to the EAU guidelines. We aimed to determine outcomes of patients with suspicious renal masses with initial finding of regular renal tissue in renal tumor biopsies.

Methods

Retrospective database analysis of 101 patients undergoing CT-guided-, percutaneous renal tumor biopsies in local anesthesia.

Results

In 23/101 patients, histopathologic evaluation of the biopsies showed regular renal tissue. Of these, two patients underwent simultaneous radiofrequency ablation (RFA), 2/23 underwent radical nephrectomy, despite negative biopsy because of radiological suspicious aspect. Overall, 12 patients underwent a second set of biopsies due to persistent clinical suspicion. Of these, five were diagnosed with RCC: three clear cell renal cell carcinoma (ccRCC) and two papillary renal cell carcinoma (pRCC). Benign tumours were found in two patients. A lymphoma was found in two patients. In 3/12 patients, also the second set of biopsies showed regular renal tissue.

Conclusion

An unsuspicious histology in CT-guided renal tumor biopsy does not preclude patients with suspicious renal masses from being diagnosed with malignancies.

Siegel RL, Miller KD, Jemal A (2017) Cancer statistics, 2017. CA Cancer J Clin 67:7–30. https://doi.org/10.3322/caac.21387 CrossRefPubMed

Gill IS, Aron M, Gervais DA, Jewett MAS (2010) Clinical practice. Small renal mass. N Engl J Med 362:624–634. https://doi.org/10.1056/NEJMcp0910041 CrossRefPubMed

Chawla SN, Crispen PL, Hanlon AL, Greenberg RE, Chen DYT, Uzzo RG (2006) The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. J Urol 175:425–431. https://doi.org/10.1016/S0022-5347(05)00148-5 CrossRefPubMed

Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H (2003) Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 170:2217–2220. https://doi.org/10.1097/01.ju.0000095475.12515.5e CrossRefPubMed

Klatte T, Patard J-J, de Martino M, Bensalah K, Verhoest G, de La Taille A, Abbou C-C, Allhoff EP, Carrieri G, Riggs SB, Kabbinavar FF, Belldegrun AS, Pantuck AJ (2008) Tumor size does not predict risk of metastatic disease or prognosis of small renal cell carcinomas. J Urol 179:1719–1726. https://doi.org/10.1016/j.juro.2008.01.018 CrossRefPubMed

Remzi M, Ozsoy M, Klingler H-C, Susani M, Waldert M, Seitz C, Schmidbauer J, Marberger M (2006) Are small renal tumors harmless? Analysis of histopathological features according to tumors 4 cm or less in diameter. J Urol 176:896–899. https://doi.org/10.1016/j.juro.2006.04.047 CrossRefPubMed

American Urological Association (2009) Guideline for management of the clinical stage 1 renal mass: [monograph on the Internet], Washington, DC

Ljungberg B, Bensalah K, Bex A, Canfield S, Dabestani S, Giles RH et al. (2015) Guidelines on renal cell carcinoma. European Association of Urology. http://uroweb.org/guideline/renal-cell-carcinoma/. Accessed 11 Nov 2017

Caoili EM, Davenport MS (2014) Role of percutaneous needle biopsy for renal masses. Semin Intervent Radiol 31:20–26. https://doi.org/10.1055/s-0033-1363839 CrossRefPubMedPubMedCentral

10.

Korbet SM (2002) Percutaneous renal biopsy. Semin Nephrol 22:254–267CrossRefPubMed

11.

Mendelssohn DC, Cole EH (1995) Outcomes of percutaneous kidney biopsy, including those of solitary native kidneys. Am J Kidney Dis 26:580–585CrossRefPubMed

12.

Lane BR, Samplaski MK, Herts BR, Zhou M, Novick AC, Campbell SC (2008) Renal mass biopsy—a renaissance? J Urol 179:20–27. https://doi.org/10.1016/j.juro.2007.08.124 CrossRefPubMed

13.

Mahmood SN, Mukhtar KN, Ahmed A, Ahmed BS (2012) CT guided renal biopsy: safety and efficacy, a study in Pakistan. PJR Pak J Radiol 22:73–77

14.

Volpe A, Kachura JR, Geddie WR, Evans AJ, Gharajeh A, Saravanan A, Jewett MAS (2007) Techniques, safety and accuracy of sampling of renal tumors by fine needle aspiration and core biopsy. J Urol 178:379–386. https://doi.org/10.1016/j.juro.2007.03.131 CrossRefPubMed

15.

Silverman SG, Gan YU, Mortele KJ, Tuncali K, Cibas ES (2006) Renal masses in the adult patient: the role of percutaneous biopsy. Radiology 240:6–22. https://doi.org/10.1148/radiol.2401050061 CrossRefPubMed

16.

Becker A, Roghmann F, Ravi P, Tian Z, Kluth LA, Gandaglia G, Noldus J, Dahlem R, Schlomm T, Graefen M, Karakiewicz PI, Trinh Q-D, Sun M (2014) Delay in nephrectomy and cancer control outcomes in elderly patients with small renal masses. Urol Int 92:455–461. https://doi.org/10.1159/000356175 CrossRefPubMed

Title: Worth a second look: outcomes of patients with initial finding of regular renal tissue in CT-guided renal tumor biopsies
Authors: M. Sadat-Khonsari
M. Papayannis
P. Schriefer
L. Kluth
C. Meyer
V. Schüttfort
M. Regier
M. Rink
F. Chun
M. Fisch
A. Becker
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2018
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-017-2170-x

2024 ASCO Annual Meeting

Springer Medicine

Worth a second look: outcomes of patients with initial finding of regular renal tissue in CT-guided renal tumor biopsies

Abstract

Introduction and objective

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction and objective

Methods

Results

Conclusion

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