SIU 2017: The Role of Renal Biopsy in Management of Small Renal Masses

Lisbon, Portugal ( The management of small renal masses (SRMs) has been assisted by the increased use of renal mass biopsy (RMB) which can avoid unnecessary surgical intervention.

In this study from a single high-volume specialist renal cancer center, 266 patients with RMB performed on SRMs < 4cm in diameter between October 2014 and December 2016 were analyzed. 

Patients were counseled and offered RMB if technically feasible. If initial histopathology was non-diagnostic, then repeat RMB was offered. RMB under US guidance was used in 80% (n=214) of cases. RMBs were reported by a specialist uro-pathologist.

The first biopsy was diagnostic in 80% (n=213) of cases. Of non-diagnostic biopsies, 24 patients underwent a second biopsy with 88% being diagnostic, giving a combined overall RMB yield of 89%. Benign histology accounted for 28% (n=75) of patients with all cases choosing surveillance and avoiding active intervention. RMB added on average 26 days to the diagnostic pathway. Complication rate was 3% (n=9) which all were <Clavien 3.

The authors presented the largest UK series of RMBs showing  a high diagnostic yield and accuracy, with low morbidity. The use of RMBs avoided unnecessary intervention in over a quarter of patients.     

Presented by: Chandran Tanabalan
Affiliation: Royal Free Hospital, London, United Kingdom

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre.Twitter: @GoldbergHanan at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal

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