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Update on Renal Mass Biopsy

  • Endourology (P Mucksavage, Section Editor)
  • Published:
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Abstract

Renal masses are diagnosed with an increasing frequency. However, a significant proportion of these masses are benign, and the majority of malignant tumors are biologically indolent. Furthermore, renal tumors are often harbored by the elderly and comorbid patients. As such, matching of renal tumor biology to appropriate treatment intensity is an urgent clinical need. Renal mass biopsy is currently a very useful clinical tool that can assist with critical clinical decision-making in patients with renal mass. Yet, renal mass biopsy is associated with limitations and, as such, may not be appropriate for all patients.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30. doi:10.3322/caac.21332.

    Article  PubMed  Google Scholar 

  2. Johnson MH, Sozio SM, Sharma R, Iyoha E, Bass EB, Allaf ME et al. Improving needle biopsy accuracy in small renal mass using tumor-specific DNA methylation markers. Cancer. 2016. doi:10.1002/cncr.3026810.18632/oncotarget.12276

  3. Smaldone MC, Egleston B, Hollingsworth JM, Hollenbeck BK, Miller DC, Kim S et al., editors. Understanding treatment disconnect and mortality trends in renal cell carcinoma using tumor registry data. ASCO Annual Meeting Proceedings; 2014

  4. Kutikov A, Smaldone MC, Egleston BL, Manley BJ, Canter DJ, Simhan J, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL Nephrometry score. Eur Urol. 2011;60(2):241–8.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Pierorazio PM, Patel HD, Johnson MH, Sozio SM, Sharma R, Iyoha E et al. Distinguishing malignant and benign renal masses with composite models and nomograms: A systematic review and meta‐analysis of clinically localized renal masses suspicious for malignancy. Cancer. 2016

  6. Shreyas Joshi AK. Understanding Mutational Drivers of Risk: An Important Step Toward Personalized Care for Patients with Renal Cell Carcinoma. EU Focus. 2016. doi:10.1016/j.euf.2016.07.008

  7. • Kutikov A, Smaldone MC, Uzzo RG, Haifler M, Bratslavsky G, Leibovich BC. Renal mass biopsy: always, sometimes, or never? Eur Urol. 2016;70(3):403–6. doi:10.1016/j.eururo.2016.04.001. The current clinical role of RMB is delineated in this editorial.

  8. Lane BR, Samplaski MK, Herts BR, Zhou M, Novick AC, Campbell SC. Renal mass biopsy—a renaissance? J Urol. 2008;179(1):20–7. doi:10.1016/j.juro.2007.08.124.

    Article  PubMed  Google Scholar 

  9. Leppert JT, Hanley J, Wagner TH, Chung BI, Srinivas S, Chertow GM, et al. Utilization of renal mass biopsy in patients with renal cell carcinoma. Urology. 2014;83(4):774–80.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Delahunt B, Samaratunga H, Martignoni G, Srigley JR, Evans AJ, Brunelli M. Percutaneous renal tumour biopsy. Histopathology. 2014;65(3):295–308. doi:10.1111/his.12495.

    Article  PubMed  Google Scholar 

  11. Chang DT, Sur H, Lozinskiy M, Wallace DM. Needle tract seeding following percutaneous biopsy of renal cell carcinoma. Korean J Urol. 2015;56(9):666–9. doi:10.4111/kju.2015.56.9.666.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mullins JK, Rodriguez R. Renal cell carcinoma seeding of a percutaneous biopsy tract. Can Urol Assoc J. 2013;7(3–4):E176–9. doi:10.5489/cuaj.499.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Soares D, Ahmadi N, Crainic O, Boulas J. Papillary renal cell carcinoma seeding along a percutaneous biopsy tract. Case Rep Urol. 2015;2015:925254. doi:10.1155/2015/925254.

    PubMed  PubMed Central  Google Scholar 

  14. Viswanathan A, Ingimarsson JP, Seigne JD, Schned AR. A single-centre experience with tumour tract seeding associated with needle manipulation of renal cell carcinomas. Can Urol Assoc J. 2015;9(11–12):E890–3. doi:10.5489/cuaj.3278.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tomaszewski JJ, Uzzo RG, Smaldone MC. Heterogeneity and renal mass biopsy: a review of its role and reliability. Cancer Biol Med. 2014;11(3):162–72. doi:10.7497/j.issn.2095-3941.2014.03.002.

    PubMed  PubMed Central  Google Scholar 

  16. Volpe A, Finelli A, Gill IS, Jewett MA, Martignoni G, Polascik TJ, et al. Rationale for percutaneous biopsy and histologic characterisation of renal tumours. Eur Urol. 2012;62(3):491–504. doi:10.1016/j.eururo.2012.05.009.

    Article  PubMed  Google Scholar 

  17. •• Patel HD, Johnson MH, Pierorazio PM, Sozio SM, Sharma R, Iyoha E, et al. Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol. 2016;195(5):1340–7. doi:10.1016/j.juro.2015.11.029. meta-analysis provide the highest level of evidence available on RMB performance.

    Article  PubMed  Google Scholar 

  18. Ambani SN, Morgan TM, Montgomery JS, Gadzinski AJ, Jacobs BL, Hawken S et al. Predictors of Delayed Intervention for Patients on Active Surveillance for Small Renal Masses: Does Renal Mass Biopsy Influence Our Decision? Urology. 2016. doi:10.1016/j.urology.2016.04.067

  19. Jeon HG, Seo SI, Jeong BC, Jeon SS, Lee HM, Choi HY, et al. Percutaneous kidney biopsy for a small renal mass: a critical appraisal of results. J Urol. 2016;195(3):568–73. doi:10.1016/j.juro.2015.09.073.

    Article  PubMed  Google Scholar 

  20. Richard PO, Jewett MA, Tanguay S, Saarela O, Liu ZA, Pouliot F et al. Safety, reliability and accuracy of small renal tumour biopsies: results from a multi-institution registry. BJU international. 2016. doi: 10.18632/oncotarget.1227610.1111/bju.13630

  21. •• Marconi L, Dabestani S, Lam TB, Hofmann F, Stewart F, Norrie J, et al. Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur Urol. 2016;69(4):660–73. doi:10.1016/j.eururo.2015.07.072. meta-analysis provides the highest level of evidence available on RMB performance.

    Article  PubMed  Google Scholar 

  22. Jason AE. Percutaneous biopsy facilitates modern treatment of renal masses. Abdominal radiology (New York). 2016;41(4):617–9. doi:10.1007/s00261-016-0644-8.

    Article  Google Scholar 

  23. Cheville JC, Lohse CM, Zincke H, Weaver AL, Blute ML. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003;27(5):612–24.

    Article  PubMed  Google Scholar 

  24. Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol. 2005;23(12):2763–71. doi:10.1200/jco.2005.07.055.

    Article  PubMed  Google Scholar 

  25. Rioux-Leclercq N, Karakiewicz PI, Trinh QD, Ficarra V, Cindolo L, de la Taille A, et al. Prognostic ability of simplified nuclear grading of renal cell carcinoma. Cancer. 2007;109(5):868–74. doi:10.1002/cncr.22463.

    Article  PubMed  Google Scholar 

  26. Ball MW, Bezerra SM, Gorin MA, Cowan M, Pavlovich CP, Pierorazio PM, et al. Grade heterogeneity in small renal masses: potential implications for renal mass biopsy. J Urol. 2015;193(1):36–40. doi:10.1016/j.juro.2014.06.067.

    Article  PubMed  Google Scholar 

  27. Richard PO, Jewett MA, Tanguay S, Saarela O, Liu ZA, Pouliot F, Kapoor A, Rendon R, Finelli A. Safety, reliability and accuracy of small renal tumour biopsies: results from a multi-institution registry. BJU Int. 2016 Aug 16. doi:10.1111/bju.13630.

  28. Osawa T, Hafez KS, Miller DC, Montgomery JS, Morgan TM, Palapattu GS, et al. Comparison of percutaneous renal mass biopsy and R.E.N.A.L. Nephrometry score nomograms for determining benign vs malignant disease and low-risk vs high-risk renal tumors. Urology. 2016;96:87–92. doi:10.1016/j.urology.2016.05.044.

    Article  PubMed  Google Scholar 

  29. Halverson SJ, Kunju LP, Bhalla R, Gadzinski AJ, Alderman M, Miller DC, et al. Accuracy of determining small renal mass management with risk stratified biopsies: confirmation by final pathology. J Urol. 2013;189(2):441–6. doi:10.1016/j.juro.2012.09.032.

    Article  PubMed  Google Scholar 

  30. Osawa T, Hafez KS, Miller DC, Montgomery JS, Morgan TM, Palapattu GS, et al. Age, gender and R.E.N.A.L. Nephrometry score do not improve the accuracy of a risk stratification algorithm based on biopsy and mass size for assigning surveillance versus treatment of renal tumors. J Urol. 2016;195(3):574–80. doi:10.1016/j.juro.2015.10.137.

    Article  PubMed  Google Scholar 

  31. • Richard PO, Jewett MA, Bhatt JR, Kachura JR, Evans AJ, Zlotta AR, et al. Renal tumor biopsy for small renal masses: a single-center 13-year experience. Eur Urol. 2015;68(6):1007–13. doi:10.1016/j.eururo.2015.04.004. This represent the largest series of RMB to date. This paper highlights the importance of high volume in RMB in order to achieve accurate results.

    Article  PubMed  Google Scholar 

  32. Ordon M, Landman J. Renal mass biopsy: “just do it”. J Urol. 2013;190(5):1638–40. doi:10.1016/j.juro.2013.08.013.

    Article  PubMed  Google Scholar 

  33. Parker PA, Alba F, Fellman B, Urbauer DL, Li Y, Karam JA, et al. Illness uncertainty and quality of life of patients with small renal tumors undergoing watchful waiting: a 2-year prospective study. Eur Urol. 2013;63(6):1122–7.

    Article  PubMed  Google Scholar 

  34. Patel HD, Riffon MF, Joice GA, Johnson MH, Chang P, Wagner AA, McKiernan JM, Trock BJ, Allaf ME, Pierorazio PM. A prospective, comparative study of quality of life among patients with small renal masses choosing active surveillance and primary intervention. J Urol. 2016 Nov;196(5):1356–1362

  35. Ljungberg B, Bensalah K, Canfield S, Dabestani S, Hofmann F, Hora M, et al. EAU guidelines on renal cell carcinoma: 2014 update. Eur Urol. 2015;67(5):913–24.

    Article  PubMed  Google Scholar 

  36. Rowe SP, Gorin MA, Gordetsky J, Ball MW, Pierorazio PM, Higuchi T, et al. Initial experience using 99mTc-MIBI SPECT/CT for the differentiation of oncocytoma from renal cell carcinoma. Clin Nucl Med. 2015;40(4):309–13. doi:10.1097/rlu.0000000000000670.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Gorin MA, Rowe SP, Allaf ME. Noninvasive determination of renal tumor histology utilizing molecular imaging. Urol Oncol. 2016;34(12):525–8. doi:10.1016/j.urolonc.2016.08.014.

    Article  PubMed  Google Scholar 

  38. •• Gorin MA, Rowe SP, Baras AS, Solnes LB, Ball MW, Pierorazio PM, et al. Prospective evaluation of (99m)Tc-sestamibi SPECT/CT for the diagnosis of renal oncocytomas and hybrid oncocytic/chromophobe tumors. Eur Urol. 2016;69(3):413–6. doi:10.1016/j.eururo.2015.08.056. The first publication examining an imaging modality the could potentially differentiate between benign and malignant renal tumors.

    Article  PubMed  Google Scholar 

  39. Volpe A, Cadeddu JA, Cestari A, Gill IS, Jewett MA, Joniau S, et al. Contemporary management of small renal masses. Eur Urol. 2011;60(3):501–15. doi:10.1016/j.eururo.2011.05.044.

    Article  PubMed  Google Scholar 

  40. Cauberg EC, Kloen S, Visser M, de la Rosette JJ, Babjuk M, Soukup V, et al. Narrow band imaging cystoscopy improves the detection of non-muscle-invasive bladder cancer. Urology. 2010;76(3):658–63. doi:10.1016/j.urology.2009.11.075.

    Article  PubMed  Google Scholar 

  41. Barwari K, de Bruin DM, Faber DJ, van Leeuwen TG, de la Rosette JJ, Laguna MP. Differentiation between normal renal tissue and renal tumours using functional optical coherence tomography: a phase I in vivo human study. BJU Int. 2012;110(8 Pt B):E415–20. doi:10.1111/j.1464-410X.2012.11197.x.

    Article  PubMed  Google Scholar 

  42. Lapini A, Minervini A, Masala A, Schips L, Pycha A, Cindolo L, et al. A comparison of hexaminolevulinate (Hexvix((R))) fluorescence cystoscopy and white-light cystoscopy for detection of bladder cancer: results of the HeRo observational study. Surg Endosc. 2012;26(12):3634–41. doi:10.1007/s00464-012-2387-0.

    Article  PubMed  Google Scholar 

  43. Lee HC, Zhou C, Cohen DW, Mondelblatt AE, Wang Y, Aguirre AD, et al. Integrated optical coherence tomography and optical coherence microscopy imaging of ex vivo human renal tissues. J Urol. 2012;187(2):691–9. doi:10.1016/j.juro.2011.09.149.

    Article  PubMed  Google Scholar 

  44. Sonn GA, Mach KE, Jensen K, Hsiung PL, Jones SN, Contag CH, et al. Fibered confocal microscopy of bladder tumors: an ex vivo study. J Endourol. 2009;23(2):197–201. doi:10.1089/end.2008.0524.

    Article  PubMed  Google Scholar 

  45. Sonn GA, Jones SN, Tarin TV, Du CB, Mach KE, Jensen KC, et al. Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy. J Urol. 2009;182(4):1299–305. doi:10.1016/j.juro.2009.06.039.

    Article  PubMed  Google Scholar 

  46. Su LM, Kuo J, Allan RW, Liao JC, Ritari KL, Tomeny PE, et al. Fiber-optic confocal laser endomicroscopy of small renal masses: toward real-time optical diagnostic biopsy. J Urol. 2016;195(2):486–92. doi:10.1016/j.juro.2015.07.115.

    Article  PubMed  Google Scholar 

  47. Wagstaff PG, Swaan A, Ingels A, Zondervan PJ, van Delden OM, Faber DJ et al. In vivo, percutaneous, needle based, optical coherence tomography of renal masses. Journal of visualized experiments : JoVE. 2015(97). doi:10.3791/52574

  48. Mourant JR, Freyer JP, Hielscher AH, Eick AA, Shen D, Johnson TM. Mechanisms of light scattering from biological cells relevant to noninvasive optical-tissue diagnostics. Appl Opt. 1998;37(16):3586–93.

    Article  CAS  PubMed  Google Scholar 

  49. Wagstaff PG, Ingels A, de Bruin DM, Buijs M, Zondervan PJ, Savci Heijink CD, et al. Percutaneous needle based optical coherence tomography for the differentiation of renal masses: a pilot cohort. J Urol. 2016;195(5):1578–85. doi:10.1016/j.juro.2015.12.072.

    Article  PubMed  Google Scholar 

  50. Silverman SG, Gan YU, Mortele KJ, Tuncali K, Cibas ES. Renal masses in the adult patient: the role of percutaneous biopsy. Radiology. 2006;240(1):6–22. doi:10.1148/radiol.2401050061.

    Article  PubMed  Google Scholar 

  51. Su SF, de Castro Abreu AL, Chihara Y, Tsai Y, Andreu-Vieyra C, Daneshmand S, et al. A panel of three markers hyper- and hypomethylated in urine sediments accurately predicts bladder cancer recurrence. Clin Cancer Res. 2014;20(7):1978–89. doi:10.1158/1078-0432.ccr-13-2637.

    Article  CAS  PubMed  Google Scholar 

  52. Khakpour G, Pooladi A, Izadi P, Noruzinia M, Tavakkoly Bazzaz J. DNA methylation as a promising landscape: a simple blood test for breast cancer prediction. Tumour Biol. 2015;36(7):4905–12. doi:10.1007/s13277-015-3567-z.

    Article  CAS  PubMed  Google Scholar 

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  1. Department of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Miki Haifler & Alexander Kutikov

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  1. Miki Haifler
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  2. Alexander Kutikov
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Correspondence to Alexander Kutikov.

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Miki Haifler and Alexander Kutikov each declare no potential conflicts of interest.

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Haifler, M., Kutikov, A. Update on Renal Mass Biopsy. Curr Urol Rep 18, 28 (2017). https://doi.org/10.1007/s11934-017-0674-y

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