Deakin University
Browse

File(s) under permanent embargo

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

Version 2 2024-06-06, 04:41
Version 1 2020-05-11, 14:18
journal contribution
posted on 2024-06-06, 04:41 authored by Melinda M Protani, Andre Joshi, Vicki WhiteVicki White, David JT Marco, Rachel E Neale, Michael D Coory, Graham G Giles, Damien M Bolton, Ian D Davis, Simon Wood, Susan J Jordan
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.

History

Journal

Journal of Clinical Urology

Volume

13

Pagination

356-363

Location

London, Eng.

ISSN

2051-4158

eISSN

2051-4166

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Copyright notice

2020, British Association of Urological Surgeons

Issue

5

Publisher

Sage Publications