OBJECTIVE: The present consensus panel convened to discuss the use of renal mass biopsy (RMB) for small renal masses, formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician.
METHODS: The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point.
RESULTS: Recommended biopsy technique: at least 2 cores, sampling different tumor regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: "non-diagnostic samples" should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful waiting candidates.
CONCLUSIONS: We report the results of an international consensus meeting on the use of renal mass biopsy for small renal masses, defining the technique, pathological interpretation and indications.
Written by:
Tsivian M, Rampersaud EN Jr, Laguna Pes MD, Joniau S, Leveillee RJ, Shingleton WB, Aron M, Kim CY, Demarzo AM, Desai MM, Meler JD, Donovan JF, Klingler HC, Sopko DR, Madden JF, Marberger M, Ferrandino MN, Polascik TJ. Are you the author?
Division of Urology, Department of Surgery, Duke University Medical Center, Durham NC, USA.
Reference: BJU Int. 2013 Oct 14. Epub ahead of print.
doi: 10.1111/bju.12470
PubMed Abstract
PMID: 24119037
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