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The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate

BACKGROUND: Small renal mass (SRM) biopsy remains under-utilized due to stigma. Meanwhile, the alarmingly high benign findings in resected kidney masses highlight the need for improved preoperative diagnosis and patient selection. METHODS: The purpose of this study is to review the success rate of S...

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Autores principales: Gao, Haijuan, Nowroozizadeh, Behdokht, Zepeda, Joaquin Ponce, Landman, Jaime, Farzaneh, Ted, Johnson, Cary, Hosseini, Hirad, Han, Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657570/
https://www.ncbi.nlm.nih.gov/pubmed/37980518
http://dx.doi.org/10.1186/s12894-023-01363-x
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author Gao, Haijuan
Nowroozizadeh, Behdokht
Zepeda, Joaquin Ponce
Landman, Jaime
Farzaneh, Ted
Johnson, Cary
Hosseini, Hirad
Han, Min
author_facet Gao, Haijuan
Nowroozizadeh, Behdokht
Zepeda, Joaquin Ponce
Landman, Jaime
Farzaneh, Ted
Johnson, Cary
Hosseini, Hirad
Han, Min
author_sort Gao, Haijuan
collection PubMed
description BACKGROUND: Small renal mass (SRM) biopsy remains under-utilized due to stigma. Meanwhile, the alarmingly high benign findings in resected kidney masses highlight the need for improved preoperative diagnosis and patient selection. METHODS: The purpose of this study is to review the success rate of SRM biopsy and to evaluate its impact on patient management. A total of 168 percutaneous image-guided core needle biopsies (CNBs) of SRMs were retrieved at a tertiary academic center between 2015 and 2019. Subsequent treatment choices, side effects and outcomes were retrospectively reviewed. RESULTS: The diagnostic rate of CNB was 86.9%. Benign neoplasms accounted for a significant portion (14.3%) of SRM. Renal cell carcinomas (RCCs) were the most common diagnoses (69.6%) as expected. In biopsy-resection correlation, the positive predictive value of CNB was 100%. Tumor typing and subtyping by CNB were highly accurate, 100% and 98.3% respectively. Nuclear grading for clear cell RCC was accurate in 83.8% cases. The CNB results had significant impact on treatment. Most patients with RCCs underwent either resection (54.1%) or ablation (33.9%), in contrast to observation in benign neoplasms (90.5%). Most importantly, the benign resection rate (3.2%) in this series was much lower than the national average. CONCLUSION: CNB provided accurate diagnoses for the majority of SRMs and revealed benign diagnoses in a subset of clinically suspicious lesions. Employment of CNB in suspicious SRM may help avoid overtreatment for benign lesions.
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spelling pubmed-106575702023-11-18 The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate Gao, Haijuan Nowroozizadeh, Behdokht Zepeda, Joaquin Ponce Landman, Jaime Farzaneh, Ted Johnson, Cary Hosseini, Hirad Han, Min BMC Urol Research BACKGROUND: Small renal mass (SRM) biopsy remains under-utilized due to stigma. Meanwhile, the alarmingly high benign findings in resected kidney masses highlight the need for improved preoperative diagnosis and patient selection. METHODS: The purpose of this study is to review the success rate of SRM biopsy and to evaluate its impact on patient management. A total of 168 percutaneous image-guided core needle biopsies (CNBs) of SRMs were retrieved at a tertiary academic center between 2015 and 2019. Subsequent treatment choices, side effects and outcomes were retrospectively reviewed. RESULTS: The diagnostic rate of CNB was 86.9%. Benign neoplasms accounted for a significant portion (14.3%) of SRM. Renal cell carcinomas (RCCs) were the most common diagnoses (69.6%) as expected. In biopsy-resection correlation, the positive predictive value of CNB was 100%. Tumor typing and subtyping by CNB were highly accurate, 100% and 98.3% respectively. Nuclear grading for clear cell RCC was accurate in 83.8% cases. The CNB results had significant impact on treatment. Most patients with RCCs underwent either resection (54.1%) or ablation (33.9%), in contrast to observation in benign neoplasms (90.5%). Most importantly, the benign resection rate (3.2%) in this series was much lower than the national average. CONCLUSION: CNB provided accurate diagnoses for the majority of SRMs and revealed benign diagnoses in a subset of clinically suspicious lesions. Employment of CNB in suspicious SRM may help avoid overtreatment for benign lesions. BioMed Central 2023-11-18 /pmc/articles/PMC10657570/ /pubmed/37980518 http://dx.doi.org/10.1186/s12894-023-01363-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gao, Haijuan
Nowroozizadeh, Behdokht
Zepeda, Joaquin Ponce
Landman, Jaime
Farzaneh, Ted
Johnson, Cary
Hosseini, Hirad
Han, Min
The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title_full The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title_fullStr The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title_full_unstemmed The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title_short The success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
title_sort success rate of small renal mass core needle biopsy and its impact on lowering benign resection rate
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657570/
https://www.ncbi.nlm.nih.gov/pubmed/37980518
http://dx.doi.org/10.1186/s12894-023-01363-x
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