For a study, researchers sought to evaluate renal mass biopsy’s (RMB) clinical value in their multistate system. RMB was helpful in the treatment of masses ≤4 cm (T1a), however, there wasn’t much research on its effectiveness in the particularly sensitive Veteran population.

In the Quality Improvement study, 130 patients with 136 RMB conducted between 06/2015 and 11/2020 were found. Analysis was done on demographics, size, pathology, therapy, and biopsy-related consequences. Of the 101 T1a masses, 89 were diagnostic cysts or weren’t decompressed cysts, and 77 satisfied the requirements for inclusion in the study of follow-up imaging compliance.

The median age was 66. With a complication risk of 2.2%, the diagnosis rate was 94.1% (128/136) for all masses and 94.1% (95/101) for T1a renal masses. Unexpectedly severe lesions with Fuhrman Grade 4, Type 2 papillary, or sarcomatoid characteristics were seen in 8/89 (9.0%) of solid T1a masses. Patients were treated with surgery or cryoablation in 57 (64%) cases, and active surveillance was chosen by 32 (36%) patients (AS). Sixteen individuals (50%) who chose AS had a neoplastic finding (oncocytoma or renal cell carcinoma (RCC)), compared to 52 patients (91%) who chose therapy. Compliance with imaging recommendations from the National Comprehensive Cancer Network was 50% and 47% for AS and treatment groups, respectively.

They discovered a high frequency of high-risk lesions and subpar follow-up imaging compliance in this VA group. To reduce risk in individuals who were lost to follow-up, aggressive biopsy methods with careful assessment of the therapy may be acceptable. Because 9% of the tiny renal tumors were extremely aggressive, biopsies may be important in determining which AS candidates to choose.

Reference: goldjournal.net/article/S0090-4295(22)00371-5/fulltext