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The role of percutaneous fine needle aspiration biopsy in the management of small renal masses without chance of nephron-sparing surgery

  • Urology - Original Paper
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Abstract

Purpose

We seek to confirm the safety and efficacy of percutaneous fine needle aspiration biopsy (FNAB) for small renal masses (SRMs) without chance of nephron-sparing surgery (NSS).

Methods

Between 2015 and 2018, 169 consecutive patients with SRMs treated in two medical centers were enrolled in the study retrospectively. All patients were evaluated to be candidates of radical nephrectomy (RN) at the initial evaluation preoperatively and they would receive the second evaluation in operation to decide the ultimate surgical regimen. Patients were divided into two groups according to FNAB.

Results

169 patients met inclusion criteria were enrolled in the finial study. The median follow-up of was 35 months (ranges from 23 to 49 months) from the first diagnosis. 83 patients received FNAB before surgery, and the other 86 patients underwent surgery immediately. The initial success rate of FNAB was 91.6% (76/83) and the rate of accuracy in identifying malignancies was 100%. 15 (18.1%) of 83 patients developed different levels of complications. 15 (18.1%) were diagnosed as benign tumors by FNAB. The initial success rate was just 50% for cystic SRMs. Complicated cystic SRMs account for 5.9% of all with a 50% benignity rate. The FNAB group had a significant lower ratio of RN than non-FNAB group (74.7% vs. 93%, p = 0.001, Pearson Chi-square test).

Conclusion

FNAB is safe and effective for SRMs without chance of NSS, and it could significantly reduce unnecessary RN.

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Acknowledgements

For their assistance in providing clinical cases from electronic medical record systems, The authors gratefully acknowledge the following departments and fellows, the Pathologic Department (Liling Li), Xiangya Hospital; the Ultrasonic department (Ying Huang), Chongqing General Hospital; the Ultrasonic department (Shigen Zhong), Chongqing General Hospital; the Department of Geriatrics Surgery (Jingyu Zhou), The Second Xiangya Hospital, Central South University.

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Authors and Affiliations

  1. Department of Urology, Chongqing General Hospital, Chongqing, China

    Wei Tong & Yi Yan

  2. Department of Gerontology, Chengfei Hospital, Chengdu, Sichuan, China

    Xianwen Lin

  3. Department of Oncology, Chongqing General Hospital, Chongqing, China

    Yizhi Xu

  4. Department of Urology, Xiangya Hospital of Central South University, Changsha, China

    Yi Yan

  5. Department of Renal Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China

    Yi Yan

Authors
  1. Wei Tong
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  2. Xianwen Lin
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  3. Yizhi Xu
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  4. Yi Yan
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by YY, XL and YX. The first draft of the manuscript was written by WT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yi Yan.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethics approval

This study was approved by the ethics committee of Chongqing general hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Tong, W., Lin, X., Xu, Y. et al. The role of percutaneous fine needle aspiration biopsy in the management of small renal masses without chance of nephron-sparing surgery. Int Urol Nephrol 52, 2223–2228 (2020). https://doi.org/10.1007/s11255-020-02558-z

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  • DOI: https://doi.org/10.1007/s11255-020-02558-z

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