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

Lisbon, Portugal (UroToday.com) 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