MP41-06 ASSESSING UTILIZATION OF RENAL MASS BIOPSY IN THE MANAGEMENT OF T1A VS. T1B RENAL MASSES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP41-06 ASSESSING UTILIZATION OF RENAL MASS BIOPSY IN THE MANAGEMENT OF T1A VS. T1B RENAL MASSES Dennis Boynton, Sabrina Noyes, Mahin Mirza, Brian Seifman, Edward Schervish, Mohit Butaney, Ji Qi, Craig Rogers, Brian R. Lane, and for the Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI Dennis BoyntonDennis Boynton More articles by this author , Sabrina NoyesSabrina Noyes More articles by this author , Mahin MirzaMahin Mirza More articles by this author , Brian SeifmanBrian Seifman More articles by this author , Edward SchervishEdward Schervish More articles by this author , Mohit ButaneyMohit Butaney More articles by this author , Ji QiJi Qi More articles by this author , Craig RogersCraig Rogers More articles by this author , Brian R. LaneBrian R. Lane More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003279.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The appropriate and optimal use of renal mass biopsy (RMB) lacks standardization and varies from physician to physician. Our objective is to explore the impact that RMB has on active surveillance (AS), nephron-sparing intervention (NSI), and radical nephrectomy (RN) rates for cT1 renal masses (cT1RM). METHODS: Data regarding 3,466 patients with a newly diagnosed cT1RM and managed with AS, NSI (partial nephrectomy, tumor ablation, and stereotactic body radiation), or RN was collected retrospectively by MUSIC-KIDNEY registrars. Patient, tumor, RMB, and management data were extracted from the registry. RESULTS: Of 3,466 patients, 626 (18%) underwent RMB, including 17% with T1a and 20% with T1b tumors. There were no significant differences in age, race, sex, GFR >or ≤60, or T1a vs. T1b in the cohorts with or without RMB. Management differed somewhat between the cohorts with vs. without RMB; AS was elected by 41% vs. 50%, NSI by 45% vs. 35%, and RN by 14% vs. 15% (p<0.001, Fig. 1). In patients with T1a masses with or without RMB, AS was elected by 44% vs. 58%, NSI by 48% vs. 36%, and RN by 7.8% vs. 6.0% (p<0.001). In contrast, management in T1b patients with or without RMB, AS was elected by 33% vs. 23%, NSI by 37% vs. 33%, and RN by 30% vs. 44% (p=0.0027, Fig. 2). CONCLUSIONS: While academic discussion of RMB tends to focus more on patients with T1a renal masses, RMB appears to impact treatment choice for T1b more than for T1a masses. Utilization of RMB in patients with T1b renal masses resulted in increased rates of NSI and AS; for every 8 RMB in this group of patients, 1 kidney will be saved from RN. More patients with T1a masses underwent intervention after RMB than those not having RMB. Perhaps providing a cancer diagnosis to patients who were initially considering AS for their ‘renal mass’ pressured them to pursue unnecessary intervention. Source of Funding: The corresponding author would like to thank the Betz Family Endowment for Cancer Research for their continued support. Funding was provided in part by the Spectrum Health Foundation. Funding was provided in part by the Value Partnerships program at Blue Cross Blue Shield of Michigan. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e556 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dennis Boynton More articles by this author Sabrina Noyes More articles by this author Mahin Mirza More articles by this author Brian Seifman More articles by this author Edward Schervish More articles by this author Mohit Butaney More articles by this author Ji Qi More articles by this author Craig Rogers More articles by this author Brian R. Lane More articles by this author for the Michigan Urological Surgery Improvement Collaborative, Ann Arbor, MI More articles by this author Expand All Advertisement PDF downloadLoading ...