A percutaneous biopsy of suspected upper tract urothelial carcinoma (UTUC) is considered contraindicated due to potential safety concerns. This study evaluated the risk of tumor seeding along the needle track following a percutaneous needle-core biopsy for UTUC, along with diagnostic yield and oncological outcomes.
We conducted a retrospective multicenter study involving 53 patients who underwent a percutaneous biopsy for upper urinary tract urothelial carcinoma between 2012 and 2022. The primary endpoint was tumor recurrence along the biopsy needle track, assessed through a centralized review of follow-up cross-sectional imaging. The secondary endpoints included biopsy yield, histological concordance in tumor stage and grade compared with final histology in cases of nephroureterectomy, complication rates, and overall oncological outcomes.
The cohort consisted of 60% male patients with a mean age of 69 yr. At diagnosis, 32% had metastatic disease. A biopsy was performed due to diagnostic uncertainty regarding renal cell carcinoma or other diseases, distant metastases, or failed endoscopic biopsy. The median follow-up imaging time was 8.3 mo. Tumor track seeding occurred in one case (1.9%) 5 mo after the procedure. Biopsy yield was 94%, with histological concordance rates of 78% for tumor stage and 100% for grade. Complications occurred in 14.8% of cases, including two (3.7%) cases of obstructive pyelonephritis requiring endoscopic management.
A percutaneous biopsy is a useful diagnostic tool for high-grade invasive upper urinary tract urothelial carcinoma, with a low risk of tumor track seeding. It provides critical histological confirmation, facilitating future research on neoadjuvant systemic therapies.
European urology oncology. 2025 Apr 21 [Epub ahead of print]
Doriane Prost, Atanas Pachev, Eric De Kerviler, Michael Baboudjian, Evanguelos Xylinas, Thomas Seisen, François Audenet, Lucas Bento, Olivier Traxer, Frédéric Panthier, Benjamin Pradere, Gauthier Marcq, Priscilla Leon, Yves Allory, Constance Thibault, Alexandre Roussel, Xavier Belin, David Chemouni, Morgan Roupret, Yann Neuzillet, François Desgrandchamps, Mathieu Roumiguie, Alexandra Masson-Lecomte, French CCAFU
Department of Urology, Paris Saint-Joseph Hospital, Paris, France., Department of Radiology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris Nord, Université Paris Cité, Paris, France., Department of Urology, Hopital Nord, Assistance Publique des Hopitaux de Marseille, Marseille, France., Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris Nord, Université Paris Cité, Paris, France., Urology, GRC 5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France., Department of Urology, Hôpital Européen Georges Pompidou, AP-HP, Université Paris Cité, Paris, France., Department of Urology, CHU Toulouse IUCT, Université UPS UT3, Toulouse, France., GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, France., Department of Urology, UROSUD, Clinique Croix Du Sud, Quint-Fonsegrives, France., Department of Urology, Claude Huriez Hospital, CHU Lille, Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France., Department of Urology, Clinique Pasteur, Royan, France., Department of Pathology, Institut Curie, Université Paris Saclay, Saint-Cloud, France., Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, APHP-Centre, Université Paris Cité, Centre de Recherche des Cordeliers INSERM UMR-S 1138, Paris, France., Department of Radiology, Foch Hospital, University Paris-Saclay - UVSQ, Suresnes, France., Department of Urology, Foch Hospital, University Paris-Saclay - UVSQ, Suresnes, France., Department of Urology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris Nord, Université Paris Cité, Paris, France., Department of Urology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris Nord, Université Paris Cité, Paris, France. Electronic address: .