Dr. Joseph and colleagues retrospectively reviewed 444 patients undergoing radical nephroureterectomy (RNU) for UTUC at Mayo Clinic between 2009 and 2017. Forty-two patients undergoing CNB before RNU were identified, and imaging and pathology were reviewed. Grade 3 or higher complications according to the Common Terminology Criteria for Adverse Events were also identified.
Dr. Joseph then summarized the results of this study. Median age at biopsy was 72.8 years. All lesions were intrarenal. Median tumor size was 3.2 cm. CT-guidance was utilized in 52.4% (n=22), ultrasound-guidance in 47.5% (n=20). Relative to RNU pathology, rate of histologic diagnosis by CNB was 95.2% (n=40). When CNB provided histologic grade (n=29, 69%), rate of concordance with surgical pathology was 86.2% (n=25). Minor and major complication rates were 14.3% (n=6) and 2.4% (n=1) respectively. At a median biopsy-to-interval imaging time of 26.2 months (1.2-76.5), no cases of CNB tract seeding were identified.
Dr. Joseph concluded that patients undergoing RNU for UTUC, CNB was a safe and effective diagnostic tool. This is the largest reported experience with CNB for diagnosis of UTUC. Additional studies are underway to compare the diagnostic accuracy of CNB to that of endoscopic biopsy.
Presented by: Jason Joseph, MD, Mayo Clinic, Rochester, Minnesota
Written by: Abhishek Srivastava, MD, Society of Urologic Oncology Fellow, Fox Chase Cancer Center, Fox Chase Cancer Center, Philadelphia, PA, Twitter: @shekabhishek at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois