MP64-05 USE OF RENAL TUMOUR BIOPSY PRIOR TO NEPHRECTOMY - AN ANALYSIS OF THE BRITISH ASSOCIATION OF UROLOGICAL SURGEONS NEPHRECTOMY OUTCOME DATA FROM 2012-2019

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You have accessJournal of UrologyCME1 Apr 2023MP64-05 USE OF RENAL TUMOUR BIOPSY PRIOR TO NEPHRECTOMY - AN ANALYSIS OF THE BRITISH ASSOCIATION OF UROLOGICAL SURGEONS NEPHRECTOMY OUTCOME DATA FROM 2012-2019 Vinson Wai Shun Chan, Jon Cartledge, Selina Bhattarai, Tze Min Wah, Leeds, United Kingdom, and British Association oF Urological Surgeons Nephrectomy Audit Vinson Wai Shun ChanVinson Wai Shun Chan More articles by this author , Jon CartledgeJon Cartledge More articles by this author , Selina BhattaraiSelina Bhattarai More articles by this author , Tze Min WahTze Min Wah More articles by this author , Leeds Leeds More articles by this author , United KingdomUnited Kingdom More articles by this author , and British Association oF Urological Surgeons Nephrectomy Audit More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003322.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Up to 30% of treated small renal masses (SRMs) are found to be benign, however, renal tumour biopsies (RTB) are not routinely recommended for histological confirmation prior to treatment. This is due to concerns of accuracy and reliability, complicating nephrectomy and doubts whether renal tumour biopsy really changes the management of patients. Therefore the aims of this study is to review the use of RTB for SRMs in the UK and its potential benefit. METHODS: The prospective British Association of Urological Surgeons nephrectomy audit was enquired from 2012-2019. Only sporadic T1N0M0 SRMs were included in the analysis. The audit covers over 80% of all nephrectomies in the UK. RESULTS: A total of 15,313 patients were included from 2012-2019. 44.7% underwent partial nephrectomy (PN) and 55.3% underwent radical nephrectomy (RN). Only 12.5% (1,914) received a pre-operative biopsy. The biopsies were found to be 92.1% (95% CI 90.8%-93.3%) diagnostic and achieved 98% (95% CI 97.5%-98.6%) concordance rate with surgical specimens for malignant and benign disease. Although renal tumour biopsy is associated with a small and significantly increased ischaemic time (mean difference: 0.94 minutes, 95% CI 0.32-1.56, p=0.003) and operative time (Figure 1), there is no significant increase in complications, blood loss, and conversion to open surgery during the nephrectomy. The use of RTB pre-operatively significantly increased from 6.67% in 2013 to 15.97% in 2013 (p<0.001). The overall benign rate of the series is 11.72%, when stratified by biopsy status, only 3.82% of patients who underwent pre-operative RTB were treated for benign histology, in comparison to 12.85% in those who did not undergo pre-operative RTB. The utilisation of RTB has clearly correlated with a fall in the percentage of benign tumors treated. (Figure 2). This suggests we may have overtreated more than 1,721 (11.2%) patients for a benign tumour, with 760 patients (9.0%) losing a kidney over a radical nephrectomy for a benign tumour. CONCLUSIONS: In conclusion, RTBs have good diagnostic rate, concordance with surgical specimen and does not worsen complication outcomes for the nephrectomy procedure. Furthermore, life-changing nephrectomies could be prevented in over 11% of patients who could have opted for active monitoring instead. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e882 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vinson Wai Shun Chan More articles by this author Jon Cartledge More articles by this author Selina Bhattarai More articles by this author Tze Min Wah More articles by this author Leeds More articles by this author United Kingdom More articles by this author British Association oF Urological Surgeons Nephrectomy Audit More articles by this author Expand All Advertisement PDF downloadLoading ...