The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion

Protani, Melinda M., Joshi, Andre, White, Victoria, Marco, David J. T., Neale, Rachel E., Coory, Michael D., Giles, Graham G., Bolton, Damien M., Davis, Ian D., Wood, Simon and Jordan, Susan J. 2020, The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion, Journal of Clinical Urology, vol. 13, no. 5, pp. 356-363, doi: 10.1177/2051415819894181.

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Title The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion
Author(s) Protani, Melinda M.
Joshi, Andre
White, VictoriaORCID iD for White, Victoria
Marco, David J. T.
Neale, Rachel E.
Coory, Michael D.
Giles, Graham G.
Bolton, Damien M.
Davis, Ian D.
Wood, Simon
Jordan, Susan J.
Journal name Journal of Clinical Urology
Volume number 13
Issue number 5
Start page 356
End page 363
Total pages 8
Publisher Sage Publications
Place of publication London, Eng.
Publication date 2020-09-01
ISSN 2051-4158
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Patterns of care
renal cell carcinoma
renal mass biopsy
small renal mass
Summary Renal mass biopsy (RMB) is advocated to improve management of small renal masses, however there is concern about its clinical utility. This study aimed to elicit opinions about the role of RMB in small renal mass management from surgeons managing renal cell carcinomas (RCC), and examine the frequency of pre-treatment biopsy in those with RCC. Methods: All surgeons in two Australian states (Queensland: n = 59 and Victoria: n = 108) who performed nephrectomies for RCC in 2012/2013 were sent questionnaires to ascertain views about RMB. Response rates were 54% for Queensland surgeons and 38% for Victorian surgeons. We used medical records data from RCC patients to determine RMB frequency. Results: Most Queensland (81%) and Victorian (59%) surgeons indicated they rarely requested RMB; however 34% of Victorians reported often requesting RMB, compared with no Queensland surgeons. This was consistent with medical records data: 17.6% of Victorian patients with T1a tumours received RMB versus 6.7% of Queensland patients (p<0.001). Surgeons’ principal concerns regarding RMB related to sampling reliability (90%) and/or histopathological interpretation (76%). Conclusions:Most surgeons report infrequent use of RMB for small renal masses, however we observed practice variation. The principal reasons for infrequent use were concerns about sampling reliability and histopathological interpretation, which may be valid in regions with less access to interventional radiologists and uropathologists. Further evidence is required to define patient groups for whom biopsy results will alter management. Level of evidence:Not applicable for this multicentre audit.
Language eng
DOI 10.1177/2051415819894181
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2020, British Association of Urological Surgeons
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Document type: Journal Article
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School of Psychology
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