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Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?

INTRODUCTION: High diagnostic performance and low morbidity for renal tumor biopsy (RTB) have been described in highly experienced centers. Here we present the five-year experience of our institute in performing RTB. The protocol used, the safety profile and the diagnostic accuracy obtained were ana...

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Autores principales: Ferrari, Matteo, Cartolari, Roberto, Barizzi, Jessica, Pereira Mestre, Ricardo, D’Antonio, Eugenia, Renard, Julien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552940/
https://www.ncbi.nlm.nih.gov/pubmed/34729222
http://dx.doi.org/10.5173/ceju.2021.3.0104
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author Ferrari, Matteo
Cartolari, Roberto
Barizzi, Jessica
Pereira Mestre, Ricardo
D’Antonio, Eugenia
Renard, Julien
author_facet Ferrari, Matteo
Cartolari, Roberto
Barizzi, Jessica
Pereira Mestre, Ricardo
D’Antonio, Eugenia
Renard, Julien
author_sort Ferrari, Matteo
collection PubMed
description INTRODUCTION: High diagnostic performance and low morbidity for renal tumor biopsy (RTB) have been described in highly experienced centers. Here we present the five-year experience of our institute in performing RTB. The protocol used, the safety profile and the diagnostic accuracy obtained were analyzed. MATERIAL AND METHODS: The study is a retrospective single-institution clinical data review of 84 consecutive RTB of small renal masses. Post-biopsy complications were reported using the Clavien-Dindo system. To measure the concordance between biopsy and nephrectomy specimens regarding histological subtype and International Society of Urological Pathology/World Health Organization (ISUP/WHO) renal cell carcinoma grade, the kappa coefficient of Cohen was used. RESULTS: Median (IQR) follow-up time was 44 (29–58) months. In total, 94% of RTB procedures were free of complications; when complications did occur, 80% were grade I and 20% were grade II. No cases of tumor seeding were observed. Combining the first and repeated biopsies the overall diagnostic rate was 85.8%. Overall, 79.1% of diagnostic RTB were malignant. In 42 surgically treated patients, the concordance between the histological results of biopsies and surgical specimens was very good for histological subtypes (k = 0.87) and moderate for tumor grade (k = 0.51). CONCLUSIONS: RTB resulted in a high safety profile. The overall diagnostic rate was 85% and an unnecessary intervention was avoided in 21% of patients. RTB showed a very good accuracy in determining the histological subtype of renal cancer while it was moderate for the tumor grade. These results are similar to those reported in larger series and support feasibility of this procedure in low-volume centers.
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spelling pubmed-85529402021-11-01 Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume? Ferrari, Matteo Cartolari, Roberto Barizzi, Jessica Pereira Mestre, Ricardo D’Antonio, Eugenia Renard, Julien Cent European J Urol Original Paper INTRODUCTION: High diagnostic performance and low morbidity for renal tumor biopsy (RTB) have been described in highly experienced centers. Here we present the five-year experience of our institute in performing RTB. The protocol used, the safety profile and the diagnostic accuracy obtained were analyzed. MATERIAL AND METHODS: The study is a retrospective single-institution clinical data review of 84 consecutive RTB of small renal masses. Post-biopsy complications were reported using the Clavien-Dindo system. To measure the concordance between biopsy and nephrectomy specimens regarding histological subtype and International Society of Urological Pathology/World Health Organization (ISUP/WHO) renal cell carcinoma grade, the kappa coefficient of Cohen was used. RESULTS: Median (IQR) follow-up time was 44 (29–58) months. In total, 94% of RTB procedures were free of complications; when complications did occur, 80% were grade I and 20% were grade II. No cases of tumor seeding were observed. Combining the first and repeated biopsies the overall diagnostic rate was 85.8%. Overall, 79.1% of diagnostic RTB were malignant. In 42 surgically treated patients, the concordance between the histological results of biopsies and surgical specimens was very good for histological subtypes (k = 0.87) and moderate for tumor grade (k = 0.51). CONCLUSIONS: RTB resulted in a high safety profile. The overall diagnostic rate was 85% and an unnecessary intervention was avoided in 21% of patients. RTB showed a very good accuracy in determining the histological subtype of renal cancer while it was moderate for the tumor grade. These results are similar to those reported in larger series and support feasibility of this procedure in low-volume centers. Polish Urological Association 2021-07-07 2021 /pmc/articles/PMC8552940/ /pubmed/34729222 http://dx.doi.org/10.5173/ceju.2021.3.0104 Text en Copyright by Polish Urological Association https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Ferrari, Matteo
Cartolari, Roberto
Barizzi, Jessica
Pereira Mestre, Ricardo
D’Antonio, Eugenia
Renard, Julien
Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title_full Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title_fullStr Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title_full_unstemmed Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title_short Percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
title_sort percutaneous biopsy of small renal mass: can diagnostic accuracy be affected by hospital volume?
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552940/
https://www.ncbi.nlm.nih.gov/pubmed/34729222
http://dx.doi.org/10.5173/ceju.2021.3.0104
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