Faculty Collaboration Database

Renal mass biopsy and thermal ablation: should biopsy be performed before or during the ablation procedure? Abdom Radiol (NY) 2017 Jun;42(6):1773-1780

Date

02/12/2017

Pubmed ID

28184961

DOI

10.1007/s00261-016-1037-8

Scopus ID

2-s2.0-85011850182 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

PURPOSE: To determine if renal mass biopsy should be performed before or during the ablation procedure with emphasis on complications and rate of ablation for renal cell carcinomas (RCC), benign tumors, and small renal masses without a histologic diagnosis.

METHODS: This HIPAA-compliant, single-center retrospective study was performed under a waiver of informed consent from the institutional review board. Two hundred eighty-four consecutive patients with a small renal mass (≤4.0 cm) treated with percutaneous thermal ablation between January 2001 and January 2015 were included. Two cohorts were identified based upon the timing of renal mass biopsy: separate session two weeks prior to ablation and same session obtained immediately preceding ablation. Clinical and pathologic data were collected including risk factors for non-diagnostic biopsy. Two-sided t test, χ ² test or Fischer's exact tests were used to evaluate differences between cohorts. Univariate and multivariate logistic regression models were constructed.

RESULTS: A histologic diagnostic was achieved more frequently in the separate session cohort [210/213 (98.6%) vs. 60/71 (84.3%), p < 0.0001]. The rate of ablation of RCC was higher in the separate session group [201/213 (94.4%) vs. 46/61 (64.7%), p = 0.001]. The rate of ablation for benign tumors [14/71 (19.7%) vs. 6/213 (2.8%), p < 0.0001] and small renal masses without a histologic diagnosis [3/213 (1.4%) vs. 11/71 (15.5%), p < 0.0001] was higher in the same session cohort. There were no high-grade complications in either cohort.

CONCLUSION: Performing renal mass biopsy prior to the day of ablation is safe, increases the rate of histologic diagnosis, and reduces the rate of ablation for benign tumors and small renal masses without a histologic diagnosis.

Author List

Wells SA, Wong VK, Wittmann TA, Lubner MG, Best SL, Ziemlewicz TJ, Hinshaw JL, Lee FT Jr, Abel EJ

Author

Tyler Wittmann MD Assistant Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Carcinoma, Renal Cell
Catheter Ablation
Contrast Media
Female
Humans
Image-Guided Biopsy
Kidney Neoplasms
Male
Middle Aged
Radiography, Interventional
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Interventional