Renal tumour biopsy (RTB) can help in risk stratification of renal tumours with implications for management, but its utilisation varies. Our objective was to report current practice patterns, experiences, and perceptions of RTB and research gaps regarding RTB for small renal masses (SRMs).
Two web-based surveys, one for health care providers (HCPs) and one for patients, were distributed via the European Association of Urology Young Academic Urologist Renal Cancer Working Group and the European Society of Residents in Urology in January 2023.
The HCP survey received 210 responses (response rate 51%) and the patient survey 54 responses (response rate 59%). A minority of HCPs offer RTB to >50% of patients (14%), while 48% offer it in <10% of cases. Most HCPs reported that RTB influences (61.5%) or sometimes influences (37.1%) management decisions. Patients were more likely to favour active treatment if RTB showed high-grade cancer and less likely to favour active treatment for benign histology. HCPs identified situations in which they would not favour RTB, such as cystic tumours and challenging anatomic locations. RTB availability (67%) and concerns about delays to treatment (43%) were barriers to offering RTB. Priority research gaps include a trial demonstrating that RTB leads to better clinical outcomes, and better evidence that benign/indolent tumours do not require active treatment.
Utilisation of RTB for SRMs in Europe is low, even though both HCPs and patients reported that RTB results can affect disease management. Improving timely access to RTB and generating evidence on outcomes associated with RTB use are priorities for the kidney cancer community.
A biopsy of a kidney mass can help patients and doctors make decisions on treatment, but our survey found that many patients in Europe are not offered this option. Better access to biopsy services is needed, as well as more research on what happens to patients after biopsy.
European urology open science. 2024 Mar 02*** epublish ***
Hannah Warren, Aleksandra Rautio, Laura Marandino, Nikolaos Pyrgidis, Lazaros Tzelves, Eduard Roussel, Stijn Muselaers, Selcuk Erdem, Carlotta Palumbo, Daniele Amparore, Zhenjie Wu, Chiara Ciccarese, Pietro Diana, Leonardo Borregales, Nicola Pavan, Angela Pecoraro, Anna Caliò, Tobias Klatte, Umberto Carbonara, Michele Marchioni, Riccardo Bertolo, Riccardo Campi, Maxine G B Tran
Division of Surgery and Interventional Sciences, University College London, London, UK., North Estonia Medical Centre, Clinic of General and Oncourology, Tallinn, Estonia., Department of Oncology, San Raffaele Hospital, Milan, Italy., Department of Urology, University Hospital, LMU Munich, Munich, Germany., Department of Urology, Sismanoglio Hospital, Athens, Greece., Department of Urology, University Hospitals Leuven, Leuven, Belgium., Department of Urology, Radboudumc, Nijmegen, The Netherlands., Department of Urology, Istanbul University, Istanbul, Turkey., Department of Urology, University of Eastern Piedmont, Vercelli, Italy., San Luigi Gonzaga Hospital, University of Turin, Turin, Italy., Department of Urology, Changhai Hospital Naval Medical University, Shanghai, China., Department of Medical Oncology, Fondaziona Policlionico Universatario A. Gemelli IRCCS, Rome, Italy., Department of Urology, Fundació Puigvert, Barcelona, Spain., Columbia University Division of Urology, Mount Sinai Medical Centre, Miami, FL, USA., University of Palmero and University of Trieste, Palmero, Italy., Department of Pathology, University of Verona, Verona, Italy., Department of Urology, Charité-Universitaetsmedizin Berlin, Berlin, Germany., Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy., Department of Medical, Oral and Biotechnological Sciences, G. D'Annunzio University of Chieti, Chieti, Italy., Department of Urology, San Carlo di Nancy Hospital, Rome, Italy., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.