Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions
Objective: To assess the safety and diagnostic accuracy of renal tumour biopsy (RTB) in patients with small renal masses (SRM) and to assess if RTB prevents overtreatment in patients with benign SRM. Material and methods: In a retrospective, single-centre study from Västmanland, Sweden, 195 adult...
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Medical journals sweden AB
2024-09-01
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| Series: | Scandinavian Journal of Urology |
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| Online Access: | https://medicaljournalssweden.se/SJU/article/view/40844 |
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| author | Bassam Mazin Hashim Abbas Chabok Börje Ljungberg Erland Östberg Farhood Alamdari |
| author_facet | Bassam Mazin Hashim Abbas Chabok Börje Ljungberg Erland Östberg Farhood Alamdari |
| author_sort | Bassam Mazin Hashim |
| collection | DOAJ |
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Objective: To assess the safety and diagnostic accuracy of renal tumour biopsy (RTB) in patients with small renal masses (SRM) and to assess if RTB prevents overtreatment in patients with benign SRM.
Material and methods: In a retrospective, single-centre study from Västmanland, Sweden, 195 adult patients (69 women and 126 men) with SRM ≤ 4 cm who had undergone RTB during 2010–2023 were included. The median age was 70 years (range 23–89). The sensitivity, specificity and predictive values of RTB were calculated using the final diagnosis as the reference standard. Treatment outcomes were recorded for a median 42-month follow-up. Complications following the biopsies were assessed according to the Clavien–Dindo system.
Results: The overall sensitivity of RTB was 95% (95% confidence interval [CI] 90% – 98%) and specificity was 100% (95% CI 95% – 100%). The positive predictive value was 100% and negative predictive value was 92%. The rate of agreement between RTB and the final diagnosis measured using kappa statistics was 0.92. Of the 195 patients, 62 underwent surgery and 48 were treated with ablation. The concordance rate between the RTB histology and final histology after surgery was 89%. Treatment was withheld in 67 of 195 patients with a benign or inconclusive RTB. No patients developed renal cell carcinoma or metastasis during follow-up. Complications occurred in two patients that were classified with Clavien–Dindo grades I and IV.
Conclusions: Percutaneous renal tumour biopsy appears to be a safe diagnostic method that provides accurate histopathological information about small renal masses and reduces overtreatment of benign SRM.
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| format | Article |
| id | doaj-art-8fa5ab6e6dc0429d994bf787c96d671b |
| institution | OA Journals |
| issn | 2168-1813 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Medical journals sweden AB |
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| series | Scandinavian Journal of Urology |
| spelling | doaj-art-8fa5ab6e6dc0429d994bf787c96d671b2025-08-20T01:57:00ZengMedical journals sweden ABScandinavian Journal of Urology2168-18132024-09-015910.2340/sju.v59.40844Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisionsBassam Mazin Hashim0https://orcid.org/0009-0006-8775-9774Abbas Chabok1https://orcid.org/0000-0001-9662-5045Börje Ljungberg2https://orcid.org/0000-0002-4121-3753Erland Östberg3https://orcid.org/0000-0002-7449-3907Farhood Alamdari4https://orcid.org/0000-0003-3589-7789Department of Urology, Region Västmanland – Uppsala University, Center for Clinical Research, Västmanland Hospital Västerås, Västerås, SwedenCentre for Clinical Research, Region Västmanland/Uppsala University, Västerås, Sweden; Division of Surgery, Danderyd University Hospital, Stockholm, SwedenDepartment of Diagnostics and Intervention, Urology and Andrology, Umeå University, Umeå, SwedenDepartment of Anaesthesia and Intensive Care, Region Västmanland – Uppsala University, Centre for Clinical Research, Västmanland Hospital Västerås, Västerås, SwedenDepartment of Urology, Region Västmanland – Uppsala University, Center for Clinical Research, Västmanland Hospital Västerås, Västerås, Sweden Objective: To assess the safety and diagnostic accuracy of renal tumour biopsy (RTB) in patients with small renal masses (SRM) and to assess if RTB prevents overtreatment in patients with benign SRM. Material and methods: In a retrospective, single-centre study from Västmanland, Sweden, 195 adult patients (69 women and 126 men) with SRM ≤ 4 cm who had undergone RTB during 2010–2023 were included. The median age was 70 years (range 23–89). The sensitivity, specificity and predictive values of RTB were calculated using the final diagnosis as the reference standard. Treatment outcomes were recorded for a median 42-month follow-up. Complications following the biopsies were assessed according to the Clavien–Dindo system. Results: The overall sensitivity of RTB was 95% (95% confidence interval [CI] 90% – 98%) and specificity was 100% (95% CI 95% – 100%). The positive predictive value was 100% and negative predictive value was 92%. The rate of agreement between RTB and the final diagnosis measured using kappa statistics was 0.92. Of the 195 patients, 62 underwent surgery and 48 were treated with ablation. The concordance rate between the RTB histology and final histology after surgery was 89%. Treatment was withheld in 67 of 195 patients with a benign or inconclusive RTB. No patients developed renal cell carcinoma or metastasis during follow-up. Complications occurred in two patients that were classified with Clavien–Dindo grades I and IV. Conclusions: Percutaneous renal tumour biopsy appears to be a safe diagnostic method that provides accurate histopathological information about small renal masses and reduces overtreatment of benign SRM. https://medicaljournalssweden.se/SJU/article/view/40844Renal tumour biopsysmall renal massesrenal tumour biopsypercutaneous renal biopsyrenal cell carcinomaoncocytoma |
| spellingShingle | Bassam Mazin Hashim Abbas Chabok Börje Ljungberg Erland Östberg Farhood Alamdari Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions Scandinavian Journal of Urology Renal tumour biopsy small renal masses renal tumour biopsy percutaneous renal biopsy renal cell carcinoma oncocytoma |
| title | Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| title_full | Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| title_fullStr | Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| title_full_unstemmed | Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| title_short | Diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| title_sort | diagnostic accuracy and safety of renal tumour biopsy in patients with small renal masses and its impact on treatment decisions |
| topic | Renal tumour biopsy small renal masses renal tumour biopsy percutaneous renal biopsy renal cell carcinoma oncocytoma |
| url | https://medicaljournalssweden.se/SJU/article/view/40844 |
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