The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion
Aims: 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 fr...
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| Veröffentlicht in: | Journal of clinical urology 2020-09, Vol.13 (5), p.356-363 |
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| container_title | Journal of clinical urology |
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| creator | Protani, Melinda M Joshi, Andre White, Victoria Marco, David JT Neale, Rachel E Coory, Michael D Giles, Graham G Bolton, Damien M Davis, Ian D Wood, Simon Jordan, Susan J |
| description | Aims:
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 |
| doi_str_mv | 10.1177/2051415819894181 |
| format | Article |
| fullrecord | <record><control><sourceid>sage_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1177_2051415819894181</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_2051415819894181</sage_id><sourcerecordid>10.1177_2051415819894181</sourcerecordid><originalsourceid>FETCH-LOGICAL-c234t-85fc8518d3cd584b1930a715501a380c039a4fdfdd6d76d61094e1508b9ba78b3</originalsourceid><addsrcrecordid>eNp1kM1qwzAQhEVpoSHNvUe9gFutZdnSsYT-QaCX9GzWlpy62JLROofc-g59wz5JbZJDKPS0w_DNwgxjtyDuAIriPhUKMlAajDYZaLhgi9lKZu_yTF-zFVFbCSWlgVSLBeu3H47H0DkeGh6dx473SMSrNgx04K3n4wT06HHneufHGaMeu-4MdsR_vr75gOPooqcZ2ZPj6C2nfdy54HkYWt8Gf8OuGuzIrU53yd6fHrfrl2Tz9vy6ftgkdSqzMdGqqbUCbWVtlc4qMFJgAUoJQKlFLaTBrLGNtbktcpuDMJkDJXRlKix0JZdMHP_WMRBF15RDbHuMhxJEOS9W_l1siiTHCE1Ny8-wj1M9-p__BbEubCk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion</title><source>Access via SAGE</source><source>Alma/SFX Local Collection</source><creator>Protani, Melinda M ; Joshi, Andre ; White, Victoria ; Marco, David JT ; Neale, Rachel E ; Coory, Michael D ; Giles, Graham G ; Bolton, Damien M ; Davis, Ian D ; Wood, Simon ; Jordan, Susan J</creator><creatorcontrib>Protani, Melinda M ; Joshi, Andre ; White, Victoria ; Marco, David JT ; Neale, Rachel E ; Coory, Michael D ; Giles, Graham G ; Bolton, Damien M ; Davis, Ian D ; Wood, Simon ; Jordan, Susan J</creatorcontrib><description>Aims:
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.</description><identifier>ISSN: 2051-4158</identifier><identifier>EISSN: 2051-4158</identifier><identifier>EISSN: 2051-4166</identifier><identifier>DOI: 10.1177/2051415819894181</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><ispartof>Journal of clinical urology, 2020-09, Vol.13 (5), p.356-363</ispartof><rights>British Association of Urological Surgeons 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c234t-85fc8518d3cd584b1930a715501a380c039a4fdfdd6d76d61094e1508b9ba78b3</cites><orcidid>0000-0002-7366-5172</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/2051415819894181$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/2051415819894181$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids></links><search><creatorcontrib>Protani, Melinda M</creatorcontrib><creatorcontrib>Joshi, Andre</creatorcontrib><creatorcontrib>White, Victoria</creatorcontrib><creatorcontrib>Marco, David JT</creatorcontrib><creatorcontrib>Neale, Rachel E</creatorcontrib><creatorcontrib>Coory, Michael D</creatorcontrib><creatorcontrib>Giles, Graham G</creatorcontrib><creatorcontrib>Bolton, Damien M</creatorcontrib><creatorcontrib>Davis, Ian D</creatorcontrib><creatorcontrib>Wood, Simon</creatorcontrib><creatorcontrib>Jordan, Susan J</creatorcontrib><title>The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion</title><title>Journal of clinical urology</title><description>Aims:
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.</description><issn>2051-4158</issn><issn>2051-4158</issn><issn>2051-4166</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kM1qwzAQhEVpoSHNvUe9gFutZdnSsYT-QaCX9GzWlpy62JLROofc-g59wz5JbZJDKPS0w_DNwgxjtyDuAIriPhUKMlAajDYZaLhgi9lKZu_yTF-zFVFbCSWlgVSLBeu3H47H0DkeGh6dx473SMSrNgx04K3n4wT06HHneufHGaMeu-4MdsR_vr75gOPooqcZ2ZPj6C2nfdy54HkYWt8Gf8OuGuzIrU53yd6fHrfrl2Tz9vy6ftgkdSqzMdGqqbUCbWVtlc4qMFJgAUoJQKlFLaTBrLGNtbktcpuDMJkDJXRlKix0JZdMHP_WMRBF15RDbHuMhxJEOS9W_l1siiTHCE1Ny8-wj1M9-p__BbEubCk</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Protani, Melinda M</creator><creator>Joshi, Andre</creator><creator>White, Victoria</creator><creator>Marco, David JT</creator><creator>Neale, Rachel E</creator><creator>Coory, Michael D</creator><creator>Giles, Graham G</creator><creator>Bolton, Damien M</creator><creator>Davis, Ian D</creator><creator>Wood, Simon</creator><creator>Jordan, Susan J</creator><general>SAGE Publications</general><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-7366-5172</orcidid></search><sort><creationdate>202009</creationdate><title>The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion</title><author>Protani, Melinda M ; Joshi, Andre ; White, Victoria ; Marco, David JT ; Neale, Rachel E ; Coory, Michael D ; Giles, Graham G ; Bolton, Damien M ; Davis, Ian D ; Wood, Simon ; Jordan, Susan J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c234t-85fc8518d3cd584b1930a715501a380c039a4fdfdd6d76d61094e1508b9ba78b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Protani, Melinda M</creatorcontrib><creatorcontrib>Joshi, Andre</creatorcontrib><creatorcontrib>White, Victoria</creatorcontrib><creatorcontrib>Marco, David JT</creatorcontrib><creatorcontrib>Neale, Rachel E</creatorcontrib><creatorcontrib>Coory, Michael D</creatorcontrib><creatorcontrib>Giles, Graham G</creatorcontrib><creatorcontrib>Bolton, Damien M</creatorcontrib><creatorcontrib>Davis, Ian D</creatorcontrib><creatorcontrib>Wood, Simon</creatorcontrib><creatorcontrib>Jordan, Susan J</creatorcontrib><collection>CrossRef</collection><jtitle>Journal of clinical urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Protani, Melinda M</au><au>Joshi, Andre</au><au>White, Victoria</au><au>Marco, David JT</au><au>Neale, Rachel E</au><au>Coory, Michael D</au><au>Giles, Graham G</au><au>Bolton, Damien M</au><au>Davis, Ian D</au><au>Wood, Simon</au><au>Jordan, Susan J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion</atitle><jtitle>Journal of clinical urology</jtitle><date>2020-09</date><risdate>2020</risdate><volume>13</volume><issue>5</issue><spage>356</spage><epage>363</epage><pages>356-363</pages><issn>2051-4158</issn><eissn>2051-4158</eissn><eissn>2051-4166</eissn><abstract>Aims:
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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><doi>10.1177/2051415819894181</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7366-5172</orcidid></addata></record> |
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| source | Access via SAGE; Alma/SFX Local Collection |
| title | The role of renal mass biopsy in the management of small renal masses – patterns of use and surgeon opinion |
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