PD4-07 CLINICAL OUTCOMES OF BOSNIAK IIF CYSTIC RENAL LESIONS: A 5-YEAR RETROSPECTIVE STUDY

Abstract

You have accessJournal of UrologyImaging/Radiology I1 Apr 2014PD4-07 CLINICAL OUTCOMES OF BOSNIAK IIF CYSTIC RENAL LESIONS: A 5-YEAR RETROSPECTIVE STUDY Krystal Leong, Jeanne Darbinian, and Jay Belani Krystal LeongKrystal Leong More articles by this author , Jeanne DarbinianJeanne Darbinian More articles by this author , and Jay BelaniJay Belani More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.228AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Bosniak renal cyst classification system is used to stratify renal cysts into their risk of malignancy. Bosniak I and II cysts are considered benign. Bosniak III and IV cysts are considered to have a high malignant potential. A Bosniak IIF renal cyst cannot clearly be categorized and needs follow-up imaging, but current literature offers scant data on the natural course of a IIF cyst, and there is no clear guideline on how best to follow these lesions. The objective of our study is to assess the radiologic progression and 5-year outcomes of Bosniak IIF renal lesions. METHODS We retrospectively identified 860 patients from January 1, 2005 through December 31, 2007 who had a possible complex renal cyst on computed tomography scan (CT), magnetic resonance imaging (MRI), or ultrasound (US). All reports which contained the words “Bosniak” or “complex” and “renal cyst” were included in the study population. Cysts were verified by CT or MRI if initial imaging was an ultrasound. Patients were included in the study cohort if they were confirmed to have a Bosniak IIF cyst and had at least 5 years of follow-up data. Of the 860 eligible patients, 112 met the inclusion criteria. Over a 5 year period, each patient was evaluated for transformation, defined as progression of Bosniak category on follow-up imaging, surgical or percutaneous treatment of the lesion, or pathologic diagnosis of renal cell carcinoma (RCC). RESULTS At 5 years, 8 of the 112 (7.1%) Bosniak IIF renal cysts underwent transformation. Of these, 3 were upgraded to Bosniak III, 1 had a complete nephrectomy at year 3, and 1 had a partial nephrectomy at year 4, both of which had benign pathology. 3 patients had surgical intervention within 8 months of follow-up and were found to have RCC. 29 of the 112 (25.9%) cysts were downgraded at some point during the five years. No patient died of RCC or developed metastatic RCC. CONCLUSIONS This is the largest cohort of Bosniak IIF renal cysts with the longest term of follow-up in the literature to date. Our data suggests that the vast majority of IIF lesions behave benignly, and the highest risk of malignant transformation is within a year of initial diagnosis. There were no patients with local invasion, metastatic spread, or death from RCC at five years of follow-up. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e53 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Krystal Leong More articles by this author Jeanne Darbinian More articles by this author Jay Belani More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...