Oncocytoma on renal mass biopsy: is it still the same histology when surgery is performed? Results from UroCCR-104 study.

To describe clinical features of patients with oncocytoma on renal biopsy (RMB), correlation with final histology on surgically treated patients, and predictive factors of discrepancy between RMB and final histology.

This was a retrospective study conducted in the framework of the UroCCR project (NCT03293563). All tumors with oncocytoma on RMB were selected and all pathological reports were reviewed. Patients with the RMB simultaneously performed with a focal treatment, synchronous bilateral tumors and ambiguous RMB report were excluded. Discrepancy between RMB and definitive histology was evaluated using a uni- and multivariable logistic regression analyses model.

Overall, 119 tumors with oncocytoma on RMB, from 15 centers, were included. Of those, 54 (45.4%) had upfront surgery and 65 (54.6%) had active surveillance (AS). In renal masses with initial active surveillance, with a median follow-up of 28 months, 23 (19.3%) underwent surgery, 4 (3.4%) received focal treatment and 38 (31.9%) remained on AS. On final pathology, only 51 of the 75 surgically treated tumors (68.0%) had oncocytoma, while 24 presented malignant tumors (mainly chromophobe carcinoma (19.2%), and hybrid oncocytic/chromophobe tumor (HOCT) (6.8%)) leading to a discrepancy of 32.0% between RMB and final pathology. The only predictive factor of a discrepancy between RMB and definitive histology was a biopsy done outside of the center (Odds ratio: 3.22 [95%-confidence interval: 1.08-9.61], p = 0.03).

Despite the increase of RMB in more and more centers, histologic discrepancy between RMB and definitive histology remains significant. This information should be discussed with patients and taken into consideration before treatment decision.

World journal of urology. 2023 Jan 12 [Epub ahead of print]

Nicolas Branger, Pierre Bigot, Géraldine Pignot, Vito Lorusso, François Audenet, Bastien Parier, Nicolas Doumerc, Martin Brenier, Evanguelos Xylinas, Romain Boissier, Morgan Rouprêt, Cecile Champy, François-Xavier Nouhaud, Hervé Lang, Thomas Charles, Richard Mallet, Damien Ambrosetti, Karim Bensalah, Jean-Christophe Bernhard

Department of Urology, Institut Paoli Calmettes Cancer Center, Marseille, France. ., Department of Urology, CHU Angers, Angers, France., Department of Urology, Institut Paoli Calmettes Cancer Center, Marseille, France., Department of Urology, Hopital Européen Georges Pompidou, Paris, France., Department of Urology, Hopital Bicêtre, Paris, France., Department of Urology, CHU Toulouse, Toulouse, France., Department of Urology, Hopital Saint-Joseph, Paris, France., Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris Cité University, Paris, France., Department of Urology, APHM, Marseille, France., Department of Urology, La Pitié Salpêtrière, Paris, France., Department of Urology, Hopital Henri Mondor, Créteil, France., Department of Urology, CHU Rouen, Rouen, France., Department of Urology, CHU Strasbourg, Strasbourg, France., Department of Urology, CHU Poitiers, Poitiers, France., Department of Urology, Polyclinique Francheville, Périgueux, France., Department of Pathology, CHU Nice, Nice, France., Department of Urology, CHU Rennes, Rennes, France., Department of Urology, CHU Bordeaux, Bordeaux, France.

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