Biopsy-based algorithm found accurate for small renal masses

Biopsy-based algorithm found accurate for small renal masses
Compared with final pathology, biopsy of small renal masses can be accurately used in a treatment algorithm to direct management, according to research published in the February issue of The Journal of Urology.

(HealthDay)—Compared with final pathology, biopsy of small renal masses (SRMs) can be accurately used in a treatment algorithm to direct management, according to research published in the February issue of The Journal of Urology.

Schuyler J. Halverson, M.D., of the University of Michigan Health System in Ann Arbor, and colleagues assessed the accuracy of a biopsy-directed treatment algorithm for correctly assigning 133 patients with SRMs (≤4 cm) to treatment or active surveillance.

Using a biopsy-directed treatment algorithm, 36 patients with SRMs were assigned to surveillance and 97 were treated. Based on the final , the researchers found that 31 percent of those patients for whom surveillance was recommended should have received treatment, while no patients moved from treatment to surveillance. Seven of the 11 misclassified cases had a biopsy indicative of grade 1 clear cell , which was upgraded to grade 2 or 3. Overall agreement between biopsy and final pathology was 92 percent; however, after adjustment of the algorithm to avoid undergrading of clear cell renal cancer, agreement improved to 97 percent, with negative and positive predictive values of 0.86 and 1.0, respectively.

"Image guided, percutaneous renal mass biopsy is highly accurate for diagnosis in most patients and provides valuable information to guide the management of SRM," the authors write. "We have shown that although slight may exist between initial biopsy and final pathology due to the heterogeneous nature of some tumors, this variability becomes clinically irrelevant when using a well-defined management protocol."

More information: Abstract
Full Text

add to favorites email to friend print save as pdf

Related Stories

Criteria for surveillance of small renal mass examined

May 07, 2012

(HealthDay) -- Active surveillance of patients with small renal masses is driven by a tumor size less than 3 cm, poor performance score (PS), and an endophytic lesion, among other patient, tumor, and surgeon ...

Recommended for you

Obama addresses West Africans on facts about Ebola

9 hours ago

President Barack Obama urged West Africans on Tuesday to wear gloves and masks when caring for Ebola patients or burying anyone who died of the disease. He also discouraged the traditional burial practice ...

Gluten-free diet benefits asymptomatic EmA+ adults

9 hours ago

(HealthDay)—Asymptomatic individuals with endomysial antibodies (EmA) benefit from a gluten-free diet (GFD), according to a study published in the September issue of Gastroenterology.

Another US health worker infected with Ebola

9 hours ago

A third American health worker has tested positive for the Ebola virus while working with patients in West Africa, the Christian missionary group SIM said Tuesday.

UN implores all countries to help on Ebola

11 hours ago

The international group Doctor Without Borders warned Tuesday that the world is 'losing the battle' against Ebola, while U.N. officials implored all countries to quickly step up their response by contributing health experts ...

Travel restrictions could worsen Ebola crisis: experts

16 hours ago

Travel restrictions could worsen West Africa's Ebola epidemic, limiting medical and food supplies and keeping out much-needed doctors, virologists said Tuesday as the disease continued its deadly spread.

User comments