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2015 ; 7
(5
): 265-74
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Percutaneous biopsy for risk stratification of renal masses
#MMPMID26425141
Blute ML Jr
; Drewry A
; Abel EJ
Ther Adv Urol
2015[Oct]; 7
(5
): 265-74
PMID26425141
show ga
The increased use of abdominal imaging has led to identification of more patients
with incidental renal masses, and renal mass biopsy (RMB) has become a popular
method to evaluate unknown renal masses prior to definitive treatment. Pathologic
data obtained from biopsy may be used to guide decisions for treatment and may
include the presence or absence of malignant tumor, renal cell cancer subtype,
tumor grade and the presence of other aggressive pathologic features. However,
prior to using RMB for risk stratification, it is important to understand whether
RMB findings are equivalent to pathologic analysis of surgical specimens and to
identify any potential limitations of this approach. This review outlines the
advantages and limitations of the current studies that evaluate RMB as a guide
for treatment decision in patients with unknown renal masses. In multiple series,
RMB has demonstrated low morbidity and a theoretical reduction in cost, if
patients with benign tumors are identified from biopsy and can avoid subsequent
treatment. However, when considering the routine use of RMB for risk
stratification, it is important to note that biopsy may underestimate risk in
some patients by undergrading, understaging or failing to identify aggressive
tumor features. Future studies should focus on developing treatment algorithms
that integrate RMB to identify the optimal use in risk stratification of patients
with unknown renal masses.