Category: Clinical Oncology: Outcomes & Complications

MP23-7 - Incidence, Diagnostic Yield, Accuracy and Impact on Perioperative Complications of Renal Mass Biopsy (RMB) on cT1aNoMo in a Contemporary Cohort (CROES renal mass registry)

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

The increasing incidence of T1 kidney tumors may trigger the inclusion of renal mass biopsy (RMB) in the diagnostic algorithm of cT1a tumors. The present report aims to depict the incidence of RMB in cT1aNoMo across the globe, to assess its the diagnostic yield and accuracy and the possible influence of preoperative RMB on complication rate after nephron-sparing surgery (NSS).


Methods :

“ad hoc” analysis of the cT1aNoMo renal masses included in the international Clinical Research Office of the Endourological Society (CROES) renal mass registry. The incidence of RMB in cT1aNoMo among continents and baseline and pathological characteristics between cases with and without RMB are compared. Diagnostic yield and accuracy were calculated in the sub-cohort that received extirpative treatment excluding ablation. Continuous variables were compared using the t-test, and categorical variables were compared using the chi-square test. K-statistics were used to analyze the agreement between the biopsy histology and surgical pathology. Logistic regression was used to assess the independent association between RMB and complications after NSS. All tests were two-sided and P-values


Results : Overall ,from 1868 cT1a NoMo kidney tumor cases, 175 (9.3%) received a preoperative RMB. Rates were higher in Europe and the Americas than in other continents. From 1465 (1433 patients) cases that received surgery (75% NSS), 104 (106 SRMs) were biopsied.  Patients who underwent RMB were more likely to have hypertension, be on dialysis [56.7% vs. 46.3% (p

The overall complication rate in the NSS sub-cohort was 16.6%, which was  not statistically different between RMB and non-RMB groups. On logistic regression analysis, RMB was not associated with an increased risk of postoperative complication after NSS [OR: 0.98, 95% CI: 0.49-1.99].


Conclusions :

In spite of high diagnostic yield and accuracy RMB is seldom performed in cT1aNoMo across the globe. There are intrinsic basal differences between the cT1a populations that receive a preoperative RMB and those that do not receive it. Preoperative RMB does not increase the likelihood of postoperative complications after NSS.

Mohammed Shahait

Fellow
Division of Urology, University of Pennsylvania
Philadelphia, Pennsylvania

Advanced Robotic Urology, University of Pennsylvania.
Interested in outcome research, new imaging modalities

Stephen Jackman

Endourology Faculty
UPMC
University of Pittsburgh
Pittsburgh, Pennsylvania

Jaime Landman

Professor and Chair
Department of Urology, University of California, Irvine, Orange, CA
Orange, California

Professor Landman completed his medical training at Columbia University. He then completed his Urology residency at Mt. Sinai Hospital in New York before moving to St. Louis to complete his minimally invasive urology training at Washington University under the guidance of Dr. Ralph Clayman. Dr. Landman’s fellowship training focused on the minimally invasive treatment of renal diseases.

Prof. Landman focuses on developing new clinical approaches to minimally invasive and more effective treatments for surgical renal diseases such as renal cell carcinoma, urolithiasis and ureteropelvic junction obstruction. For the past decade, his clinical practice has been focused almost exclusively on the minimally invasive management of kidney disease with a focus on renal oncology and urolithiasis.

Since 2002 Dr. Landman has directed an active minimally invasive urology laboratory. His laboratory has focused largely on innovative minimally invasive solutions in the diagnosis and treatment of urologic malignancies, kidney stones and the development of minimally invasive surgical technologies.

A major focus of Dr. Landman’s efforts has been the didactic and technical training of students, residents and fellows. Dr. Landman has had an active role in medical student and resident education since 2001. Since 2002 Dr. Landman has been actively directing the Endourology sanctioned clinical and research fellowship, and he was until recently the program director for the UC Irvine Urology residency. Dr. Landman engendered and currently directs the LIFT (Leadership Innovation Fellowship Training) program at UC Irvine and has focused on helping medical students become academic leaders in Urology.

A current focus of Dr. Landman’s research remains didactic and technical training for students, residents and fellows. His research team continues to develop novel strategies for surgical education.

Eric Lechevallier

Marseille, Provence-Alpes-Cote d'Azur, France

Ignace Billiet

Kortrijk, Brussels Hoofdstedelijk Gewest, Belgium

Laurent Fossion

Veldhoven, Noord-Brabant, Netherlands

Yilmaz Aslan

University of Health Sciences, Ankara Numune Research and Training Hospital
Department of Urology
Ankara, Ankara, Turkey

Maria Pilar Laguna Pes

Amsterdam, Noord-Holland, Netherlands