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Does renal mass biopsy influence multidisciplinary treatment recommendations?
Lobo, Jennifer M; Clements, Matthew B; Bitner, Daniel P; Mikula, Matthew D; Noona, Sean W; Sultan, Mark I; Cathro, Helen P; Lambert, Drew L; Schenkman, Noah S; Krupski, Tracey L.
Afiliación
  • Lobo JM; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
  • Clements MB; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Bitner DP; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Mikula MD; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Noona SW; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Sultan MI; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Cathro HP; Department of Pathology, University of Virginia, Charlottesville, VA, USA.
  • Lambert DL; Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA.
  • Schenkman NS; Department of Urology, University of Virginia, Charlottesville, VA, USA.
  • Krupski TL; Department of Urology, University of Virginia, Charlottesville, VA, USA.
Scand J Urol ; 54(1): 27-32, 2020 Feb.
Article en En | MEDLINE | ID: mdl-31868063
Purpose: To examine how a multidisciplinary team approach incorporating renal mass biopsy (RMB) into decision making changes the management strategy.Methods: A multidisciplinary team comprised of a radiology proceduralist, a pathologist and urologists convened monthly for renal mass conference with a structured presentation of patient demographics, co-mborbidities, tumor pathology, laboratory and radiographic features. Biopsy protocol was standardized to an 18-gauge core needle biopsy using a sheathed apparatus under renal ultrasound guidance. Biopsy diagnostic rate, and concordance with nephrectomy specimens were summarized. Descriptive statistics were used to evaluate influence of RMB on management decisions.Results: A total of 83 patients with a ≤4 cm mass were discussed, and 66% of patients underwent RMB. Of those, 87% were diagnostic with 9% of core biopsies showing benign pathology. Active surveillance (AS) was recommended for 34% of patients with biopsy data as compared to 64% of those without biopsy. Ablation was recommended for 38% of the biopsy cohort compared to 7% without biopsy. Partial nephrectomy rates were similar for both cohorts, approximately 17% and 22%, respectively. Our complication rate was 1.5%, with only 1 Clavien-Dindo Grade 2 complication. Histology was concordant in 93% of patients that ultimately underwent partial nephrectomy after biopsy.Conclusions: Over half of our SRM patients underwent a RMB that provided a diagnosis in 85% of cases. RMB aided in shared decision making by providing insight into the biology of renal masses, which helps to guide multidisciplinary management and consideration of nephron sparing options.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Renales / Angiomiolipoma / Adenoma Oxifílico / Técnicas de Ablación / Espera Vigilante / Toma de Decisiones Clínicas / Neoplasias Renales / Nefrectomía Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Scand J Urol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suecia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Renales / Angiomiolipoma / Adenoma Oxifílico / Técnicas de Ablación / Espera Vigilante / Toma de Decisiones Clínicas / Neoplasias Renales / Nefrectomía Tipo de estudio: Diagnostic_studies / Guideline / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Scand J Urol Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suecia