FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2154865391> ?p ?o ?g. }

• W2154865391 endingPage "424" @default.
• W2154865391 startingPage "423" @default.
• W2154865391 abstract "The abundant use of cross-sectional imaging has markedly increased the diagnosis of small renal masses (SRMs) (1). A strict definition of small renal masses is lacking and most authors consider lesions < 4cm as small (2). According to the literature, 20% of SRMs are benign in formal histological results and SRMs represent 48-66% of diagnosed renal cell cancers (RCC) (1, 2). In a meta-analysis by Chawla et al. (3) the incidence of metastasis of SRMs is 1% after a 3-year follow up. Nevertheless, the radiological features of SRMs are insufficient to describe the biological potential and predict the natural history of SRMs (4). Therefore, studies have demonstrated overtreatment of patients with benign SRMs which were misdiagnosed as malignant on the preoperative imaging (2, 4). The inability of modern imaging techniques (i.e. computerized tomography (CT) to differentiate benign from malignant SRMs has renewed interest in renal mass biopsy (RMB). Furthermore, the renewed interest in RMB is closely associated with novel minimal invasive treatments for SRMs (i.e. cryotherapy and radiofrequency ablation (RFA), improved biopsy techniques and pathological evaluation (5).RMB aims to determine eventual malignancy, type and grade of the evaluated SRM with high specificity and sensitivity for the presence of malignancy. The diagnostic accuracy of RMB has improved through the last years, as has been demonstrated in a recent meta-analysis by lane et al. (5) The authors compared the diagnostic accuracy of RMB with reports stratified pre- and post-2001, showing an improvement from 88% to 94%. The diagnostic value of RMB refers not only to the differential diagnosis of benign versus malignant tumors, but also to the definition of the histological subtype of the tumor (i.e. renal cell carcinoma (RCC). Neuzillet et al. (6) showed high concordance (more than 91%), between the histological subtype findings of the RMB and the final nephrectomy specimen for SRMs (8).The recent evolution of minimally invasive treatment options for SRMs highlights even more the important role of the RMB, before cryotherapy or RFA where no biopsy is possible (5). CT guided RMB has been demonstrated to improve the differential diagnosis of SRMs and prevent overtreatment (7). Furthermore, RMB can nowadays change the management of SRM which was doubtful a few years ago (8). A benign or SRM of low malignant potential can be managed with active surveillance protocols or ablative techniques especially in elderly and unfit patients. Moreover, the positive predictive value of imaging findings is so high that a negative RMB does not alter management (5). Furthermore, RMB is indicated in metastatic patients, before starting systemic therapy (7). In recent studies, RMB-related complications such as gross hematuria, renal hematoma requiring intervention (i.e. admission, transfusion or nephrectomy), arterio-venous fistula or pneumothorax are extremely rare (< 1%) (9).The traditional concern of needle tract tumor seeding is based on only six reports published before 1993 (5). The majority of these cases were transitional cell carcinoma of the upper urinary tract, which is a contraindication for RMB. Interestingly, since 1993 no case of tumor seeding has been reported, most probably because of the innovative needle introducers which isolate the sample from the surrounding tissues.Repeat RMB is suggested in cases of a non-diagnostic result due to an inadequate or insufficient specimen (9). In order to reduce the incidence of such non-diagnostic RMB there are several recommendations. RMB guided by CT and/or real time ultrasound increases diagnostic accuracy (10). Two cores of 15-22mm in length each taken by an 18-gauge biopsy gun provide reliable specimens (11). Furthermore, by targeting the peripheral area of the SRM, potential central necrosis is avoided. Moreover, by placing the tip of the needle a few millimeters outside the SRM, the specimen includes the capsule of the tumor. New molecular techniques such as, polymerase chain reaction and fluorescence in situ hybridization, improve the accuracy of tumor sub-typing (12). Moreover, modern immunocytochemistry can contribute to the differential diagnosis between RCC and several benign tumors, such as oncocytomas (13).Nowadays, RBM has become an established tool for the management of SRMs as indicated in the recent European Association of Urology (EAU) guidelines (14). It is recommended for the diagnosis, follow-up surveillance and ablative therapies of SRMs. The future looks promising for RMB in the evaluation of SRMs, especially with the implications of molecular and cytogenetic profiling of the specimen. Eventually, RMB might be able to predict the prognosis of the SRM and guide its treatment. There is no easy answer to the difficult question, to biopsy a SRM or not, however the trend will be to continue to perform the biopsy." @default.
• W2154865391 created "2016-06-24" @default.
• W2154865391 creator A5049857719 @default.
• W2154865391 creator A5078671950 @default.
• W2154865391 creator A5085722796 @default.
• W2154865391 date "2012-03-01" @default.
• W2154865391 modified "2023-09-26" @default.
• W2154865391 title "To Biopsy a Small Renal Mass, or Not?" @default.
• W2154865391 cites W2020012641 @default.
• W2154865391 cites W2031684325 @default.
• W2154865391 cites W2039870513 @default.
• W2154865391 cites W2040228974 @default.
• W2154865391 cites W2048413997 @default.
• W2154865391 cites W2048989117 @default.
• W2154865391 cites W2064943663 @default.
• W2154865391 cites W2071061528 @default.
• W2154865391 cites W2072741873 @default.
• W2154865391 cites W2093017328 @default.
• W2154865391 cites W2163718079 @default.
• W2154865391 cites W2166597765 @default.
• W2154865391 cites W2167832878 @default.
• W2154865391 cites W2911611736 @default.
• W2154865391 doi "https://doi.org/10.5812/numonthly.3991" @default.
• W2154865391 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3614265" @default.
• W2154865391 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/23573459" @default.
• W2154865391 hasPublicationYear "2012" @default.
• W2154865391 type Work @default.
• W2154865391 sameAs 2154865391 @default.
• W2154865391 citedByCount "1" @default.
• W2154865391 countsByYear W21548653912014 @default.
• W2154865391 crossrefType "journal-article" @default.
• W2154865391 hasAuthorship W2154865391A5049857719 @default.
• W2154865391 hasAuthorship W2154865391A5078671950 @default.
• W2154865391 hasAuthorship W2154865391A5085722796 @default.
• W2154865391 hasBestOaLocation W21548653911 @default.
• W2154865391 hasConcept C126322002 @default.
• W2154865391 hasConcept C126894567 @default.
• W2154865391 hasConcept C2775934546 @default.
• W2154865391 hasConcept C2780091579 @default.
• W2154865391 hasConcept C2780227381 @default.
• W2154865391 hasConcept C2781087799 @default.
• W2154865391 hasConcept C2992994880 @default.
• W2154865391 hasConcept C71924100 @default.
• W2154865391 hasConceptScore W2154865391C126322002 @default.
• W2154865391 hasConceptScore W2154865391C126894567 @default.
• W2154865391 hasConceptScore W2154865391C2775934546 @default.
• W2154865391 hasConceptScore W2154865391C2780091579 @default.
• W2154865391 hasConceptScore W2154865391C2780227381 @default.
• W2154865391 hasConceptScore W2154865391C2781087799 @default.
• W2154865391 hasConceptScore W2154865391C2992994880 @default.
• W2154865391 hasConceptScore W2154865391C71924100 @default.
• W2154865391 hasIssue "2" @default.
• W2154865391 hasLocation W21548653911 @default.
• W2154865391 hasLocation W21548653912 @default.
• W2154865391 hasLocation W21548653913 @default.
• W2154865391 hasLocation W21548653914 @default.
• W2154865391 hasOpenAccess W2154865391 @default.
• W2154865391 hasPrimaryLocation W21548653911 @default.
• W2154865391 hasRelatedWork W2030779837 @default.
• W2154865391 hasRelatedWork W2039870513 @default.
• W2154865391 hasRelatedWork W2071728731 @default.
• W2154865391 hasRelatedWork W2336945491 @default.
• W2154865391 hasRelatedWork W2765194927 @default.
• W2154865391 hasRelatedWork W2796192438 @default.
• W2154865391 hasRelatedWork W2803109591 @default.
• W2154865391 hasRelatedWork W2899940549 @default.
• W2154865391 hasRelatedWork W2990900483 @default.
• W2154865391 hasRelatedWork W3202782417 @default.
• W2154865391 hasVolume "4" @default.
• W2154865391 isParatext "false" @default.
• W2154865391 isRetracted "false" @default.
• W2154865391 magId "2154865391" @default.
• W2154865391 workType "article" @default.