Introduction: Renal mass biopsy (RMB) is still underutilized, partially because many urologists argue that it does not substantially influence the management of renal masses. We sought to evaluate the influence of RMB on the management of renal tumours in our institution. Materials and Methods: A total of 387 RMBs performed at our institution from January 2016 to June 2020 were included. Patient demographics, mass size, biopsy result, and subsequent clinical management were retrospectively reviewed. Results: The mean mass size was 47.8 mm. Fifty-six percentage of tumours ≤40 mm (247) and 8% of tumours >40 mm (64) were biopsied. Seventy-six RMBs of disseminated tumours were performed. 14.9% of RMBs were non-diagnostic, and 27.1% of RMBs of tumours ≤40 mm were benign. The majority of tumours with first non-diagnostic RMB followed by histopathological verification were found to be malignant. There was significantly more conservative management and no radical nephrectomies in the benign biopsy group. One case of Clavien-Dindo grade ≥2 complication occurred. Conclusions: RMB result affects treatment decisions. Ultrasound-guided RMB is a safe procedure, and performing biopsies of tumours ≤40 mm may reduce the number of unnecessary interventions. Non-diagnostic RMBs should be repeated or treated as malignant.

1.
Herrera-Caceres
JO
,
Finelli
A
,
Jewett
MAS
.
Renal tumor biopsy: indicators, technique, safety, accuracy results, and impact on treatment decision management
.
World J Urol
.
2019
;
37
(
3
):
437
43
. .
2.
Marconi
L
,
Dabestani
S
,
Lam
TB
,
Hofmann
F
,
Stewart
F
,
Norrie
J
,
Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy
.
Eur Urol
.
2016
;
69
(
4
):
660
73
.
3.
Patel
RM
,
Parkhomenko
E
,
Kaler
KS
,
Okhunov
Z
,
Clayman
RV
,
Landman
J
.
Renal mass biopsy: an oncological conundrum
.
Curr Opin Urol
.
2018
;
28
(
4
):
360
3
. .
4.
Shahait
M
,
Jackman
S
,
Landman
J
,
Lechevallier
E
,
Billiet
I
,
Fossion
L
,
Utilization and operative influence of renal mass biopsy in the small renal mass: analysis from the clinical research office of the endourological society small renal mass registry
.
J Endourol
.
2020
;
34
(
1
):
99
106
.
5.
Richard
PO
,
Lavallée
LT
,
Pouliot
F
,
Komisarenko
M
,
Martin
L
,
Lattouf
JB
,
Is routine renal tumor biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?
J Urol
.
2018
;
200
(
4
):
731
6
.
6.
Ambani
SN
,
Wolf
JS
 Jr
.
Renal mass biopsy for the small renal mass
.
Urol Oncol
.
2018
;
36
(
1
):
4
7
. .
7.
Millet
I
,
Doyon
FC
,
Hoa
D
,
Thuret
R
,
Merigeaud
S
,
Serre
I
,
Characterization of small solid renal lesions: can benign and malignant tumors be differentiated with CT?
AJR Am J Roentgenol
.
2011
;
197
(
4
):
887
96
.
8.
Ljungberg
B
,
Albiges
L
,
Bensalah
K
,
Bex
A
,
Giles
RH
,
Hora
M
,
EAU guidelines on renal cell carcinoma 2020
. Edn. presented at the EAU Annual Congress Amsterdam;
2020
.
9.
Herrera-Caceres
JO
,
Finelli
A
,
Jewett
MAS
.
Renal tumor biopsy: indicators, technique, safety, accuracy results, and impact on treatment decision management
.
World J Urol
.
2019
;
37
(
3
):
437
43
. .
10.
Okhunov
Z
,
Gorin
MA
,
Jefferson
FA
,
Afyouni
AS
,
Allaf
ME
,
Pierorazio
PM
,
Can preoperative renal mass biopsy change clinical practice and reduce surgical intervention for small renal masses?
Urol Oncol
.
2021
;
39
:
735.e17
23
.
11.
Ma
LX
,
Craig
KM
,
Mosquera
JM
,
Robinson
BD
,
Scherr
DS
,
Pizzo
JD
,
Contemporary results and clinical utility of renal mass biopsies in the setting of ablative therapy: a single center experience
.
Cancer Treat Res Commun
.
2020
;
25
:
100209
.
12.
Gillis
CJ
,
Rendon
R
,
MacDonald
LP
,
Jewett
MAS
,
French
C
,
Ajzenberg
H
,
Identification of tumor size as the only factor associated with nondiagnostic biopsies in patients with small renal masses
.
Can Urol Assoc J
.
2020
;
14
(
5
):
E220
3
.
13.
Dave
CN
,
Seifman
B
,
Chennamsetty
A
,
Frontera
R
,
Faraj
K
,
Nelson
R
,
Office-based ultrasound-guided renal core biopsy is safe and efficacious in the management of small renal masses
.
Urology
.
2017
;
102
:
26
30
.
14.
Patel
RM
,
Okhunov
Z
,
Jiang
P
,
Tapiero
S
,
Landman
J
.
Office-based renal tumor biopsy: a paradigm change in the management of a small renal mass?
Curr Urol Rep
.
2021
;
22
(
9
):
43
. .
15.
Siekiera
J
,
Jasinski
M
,
Mikołajczak
W
.
Radiofrequency ablation of small renal masses in comorbid patients
.
Wideochir Inne Tech Maloinwazyjne
.
2018
;
13
(
2
):
212
4
. .
16.
Doolittle
J
,
Piotrowski
J
,
Zuk
K
,
Jacobsohn
K
,
Langenstroer
P
,
See
W
,
Evolving trends for selected treatments of T1a renal cell carcinoma
.
Urology
.
2019
;
132
:
136
42
.
17.
Shah
PH
,
Alom
MA
,
Leibovich
BC
,
Thompson
RH
,
Uzzo
RG
,
Kavoussi
LR
,
The temporal association of robotic surgical diffusion with overtreatment of the small renal mass
.
J Urol
.
2018
;
200
(
5
):
981
8
.
18.
Kurban
LAS
,
Vosough
A
,
Jacob
P
,
Prasad
D
,
Lam
T
,
Scott
N
,
Pathological nature of renal tumors: does size matter?
Urol Ann
.
2017
;
9
(
4
):
330
4
.
19.
Lim
A
,
O’Neil
B
,
Heilbrun
ME
,
Dechet
C
,
Lowrance
WT
.
The contemporary role of renal mass biopsy in the management of small renal tumors
.
Front Oncol
.
2012
;
2
:
106
. .
20.
Ozambela
M
 Jr
,
Wang
Y
,
Leow
JJ
,
Silverman
SG
,
Chung
BI
,
Chang
SL
.
Contemporary trends in percutaneous renal mass biopsy utilization in the United States
.
Urol Oncol
.
2020
;
38
(
11
):
835
43
. .
21.
Alle
N
,
Tan
N
,
Huss
J
,
Huang
J
,
Pantuck
A
,
Raman
SS
.
Percutaneous image-guided core biopsy of solid renal masses: analysis of safety, efficacy, pathologic interpretation, and clinical significance
.
Abdom Radiol
.
2018
;
43
(
7
):
1813
9
. .
22.
Lobo
JM
,
Clements
MB
,
Bitner
DP
,
Mikula
MD
,
Noona
SW
,
Sultan
MI
,
Does renal mass biopsy influence multidisciplinary treatment recommendations?
Scand J Urol
.
2020
;
54
(
1
):
27
32
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.