Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the role of renal mass biopsy in the management of kidney cancer

Lavallée, Luke T.; McAlpine, Kristen; Kapoor, Anil; Pouliot, Frédéric; Mason, Ross; Violette, Philippe D.; Bansal, Rahul; Richard, Patrick O.; Karakiewicz, Pierre I.; Bhindi, Bimal; Maloni, Ranjena; Pautler, Stephen E.; Lattouf, Jean‐Baptiste; Kassouf, Wassim; Tanguay, Simon; So, Alan; Rendon, Ricardo; Breau, Rodney H.

doi:10.5489/cuaj.6176

Cited by 4 publications

(1 citation statement)

References 42 publications

(86 reference statements)

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“…Histopathologycally, CCDC arise from the medulla as have been previously noted in the literatures, which distinguish them from the CRCCs that arise from the renal cortex [ 11 ]. Other tumors may also involve the renal medulla, e.g., transitional cell carcinoma [ 12 ], squamous cell carcinoma [ 13 ] and chromophobe renal cell carcinoma [ 14 ]. It is difficult to differentiate CCDC from other tumors if only relying on tumor position [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

CT and MRI findings of cystic renal cell carcinoma: comparison with cystic collecting duct carcinoma

Zhu

Ling

et al. 2021

Cancer Imaging

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Background Cystic renal cell carcinoma (CRCC) and cystic collecting duct carcinoma (CCDC) share similar oncogeni and some imaging findings. The aim of this study was to characterize the clinical and CT imagings features of CRCC and CCDC. Methods Thirty-three patients with CRCC and thirteen patients with CCDC with pathologically proven were retrospectively studied. Tumor characteristics were assessed. Results On CT imaging, 33 patients(100 %) with CRCC and 13 patients(100 %) with CCDC, tumors calcifications (8 vs. 9, P < 0.0001), had a clear boundary (capsule sign, 30 vs. 2, P < 0.0001), infiltrative appearance (1 vs. 13, P < 0.0001), exogenous appearance (29 vs. 3, P < 0.0001), invaded the renal pelvis or ureter (1 vs. 10, P < 0.0001), hemorrhage (1 vs. 10, P < 0.0001), had retroperitoneal lymph node or distant metastasis (2 vs. 10, P < 0.0001), thickened enhancing internal septations (31 vs. 2, P < 0.0001), and mural soft-tissue nodules (21 vs. 1, P < 0.0001). On MR imaging,13 patients(39 %) with CRCC and 4 patients(31 %) with CCDC, all CRCCs appeared hypointense on T1-weighted images and hyperintense on T2-weighted images, however, all CCDCs appeared hypointense on T1-weighted images and hypointense on T2-weighted images(P < 0.0001). 33 patients with CRCC, they were all alive from3 years to 10 years follow-up, however, 13 patients with CCDC, of which 11 patients were able to be followed up, and 9 patients expired within 5 years of the initial diagnosis and the others are currently still alive. Conclusions Distinguishing features of CRCC and CCDC included calcifications, capsule signs, infiltrative appearance, metastasis, internal septations, mural nodules and signal on CT or MR images. These imaging features may help in differentiating the two renal tumor types.

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Section: Discussionmentioning

confidence: 99%

CT and MRI findings of cystic renal cell carcinoma: comparison with cystic collecting duct carcinoma

Zhu

Ling

et al. 2021

Cancer Imaging

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Evolving Role of Urologists in the Management of Advanced Renal Cell Carcinoma

Kapoor

Kim

Goucher

et al. 2020

Urologic Clinics of North America

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Optimizing the management of patients with small renal masses in a Canadian context: A Markov decision-analysis model

McAlpine¹,

Sud²,

Finelli³

et al. 2021

CUAJ

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Introduction: The management of patients with a small renal mass (SRM) varies significantly. The objective of this study was to determine which initial management strategy resulted in the greatest quality-adjusted life months (QALM) for an index patient with a SRM. Methods: A Markov decision analysis was used to determine the effect of 1) treating patients with a partial nephrectomy (PN); 2) active surveillance; and 3) renal mass biopsy on QALM over a 10-year horizon. All relevant health states were modelled. Biopsy sensitivity and specificity were modelled assuming an 80% prevalence of cancer using procedural pathology as the gold standard. Health state utilities were obtained from the Tufts Medical Centre Cost-Effective Analysis Registry. Deterministic sensitivity analyses were used to test key assumptions. Results: Over a 10-year time horizon for a 70-year-old male with a 2 cm SRM, the biopsy strategy resulted in 38.07 QALM, whereas treating all patients with PN resulted in 37.69 QALM and active surveillance in 36.25 QALM. The model was most sensitive to the probability that a patient would remain alive at baseline. Biopsy was the preferred strategy when sensitivity was greater than 77%. As the underlying probability of cancer increased, the threshold of renal mass biopsy sensitivity to still favor biopsy increased. Conclusions: Renal mass biopsy is the preferred initial management strategy for an index patient with a SRM to optimize QALM. When the probability of cancer is high, centers should aim for a sensitivity of at least 77% in order to consider a biopsy first strategy.

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Kidney Cancer Research Network of Canada (KCRNC) consensus statement on the role of renal mass biopsy in the management of kidney cancer

Cited by 4 publications

References 42 publications

CT and MRI findings of cystic renal cell carcinoma: comparison with cystic collecting duct carcinoma

CT and MRI findings of cystic renal cell carcinoma: comparison with cystic collecting duct carcinoma

Evolving Role of Urologists in the Management of Advanced Renal Cell Carcinoma

Optimizing the management of patients with small renal masses in a Canadian context: A Markov decision-analysis model

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