BALTIC17: Benefits of renal mass biopsy in selected patients

26 May 2017

For selected patients renal mass biopsy can offer benefits such as avoiding surgery and in support of the decision-making by doctors whose patients have small renal masses (SRMs).

“There are clinical reasons for a wider use of renal tumour biopsy and one of these is the reduction of unnecessary surgeries for patients with benign pathology,” said Prof. Alessandro Volpe (IT) during the opening plenary session of the 4th Baltic Meeting held in conjunction with EAU and which opened today in Vilnius, Lithuania.

In his lecture, Volpe gave a comprehensive overview of the reasons for expanding the use of renal mass biopsy which, according to him, has limited use due to concerns in safety.

“Among the safety concerns includes the risk of bleeding and needle-track seeding,” he said whilst adding that some doctors are also concerned about local reaction that could challenge subsequent surgery.

He also mentioned that there are issues on techniques such as the non-diagnostic nature of a biopsy and the possibility of sampling errors.

On the other hand, Volpe said renal mass biopsy can provide benefits besides reducing surgical interventions.

“Renal mass biopsy can support our decision-making in patients with SRMs and who are candidates for non-surgical treatment,” he explained. “Aside from that renal mass biopsy also gives support in the choice of the best treatment for patients with metastatic renal cell carcinoma (RCC).”

Among the indications for renal mass biopsy are for renal tumours with indeterminate imaging, in patients with SRMs who are candidates for non-surgical treatment, and those with metastatic RCC who are not candidates for cytoreductive nephrectomy.

In his concluding remarks, Volpe said that renal mass biopsy is easily feasible and is a minimally invasive procedure.

“Moreover, clinically significant complications are rare and the diagnostic yield is satisfactory in experienced surgeons,” he noted as he added that diagnostic biopsies have a high accuracy for malignancy and histotype.