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• W2911456196 abstract "No AccessJournal of UrologyAdult Urology1 Jun 2019Risk Factors for Complications and Nondiagnostic Results following 1,155 Consecutive Percutaneous Core Renal Mass BiopsiesThis article is commented on by the following:Editorial CommentEditorial Comment Natasza M. Posielski, Anthony Bui, Shane A. Wells, Sara L. Best, Lori Mankowski Gettle, Timothy J. Ziemlewicz, Meghan G. Lubner, J. Louis Hinshaw, Fred T. Lee, Glenn O. Allen, Stephen Y. Nakada, and E. Jason Abel Natasza M. PosielskiNatasza M. Posielski Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Anthony BuiAnthony Bui Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Shane A. WellsShane A. Wells Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon. More articles by this author , Sara L. BestSara L. Best Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Lori Mankowski GettleLori Mankowski Gettle Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Timothy J. ZiemlewiczTimothy J. Ziemlewicz Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon. More articles by this author , Meghan G. LubnerMeghan G. Lubner Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon and Philips. More articles by this author , J. Louis HinshawJ. Louis Hinshaw Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Fred T. LeeFred T. Lee Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Glenn O. AllenGlenn O. Allen Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , Stephen Y. NakadaStephen Y. Nakada Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author , and E. Jason AbelE. Jason Abel §Correspondence: Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave., Madison, Wisconsin 53705 (telephone: 920-740-3911; FAX: 608-263-4563; e-mail: E-mail Address: [email protected]). Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000113AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The purpose of this study was to evaluate patient, tumor and technical factors associated with procedural complications and nondiagnostic findings following percutaneous core renal mass biopsy. Materials and Methods: We reviewed core renal mass biopsies from 2000 to 2017. Complications at 30 days or less were graded using the Clavien-Dindo system. Univariate and multivariable analyses were done to evaluate associations between clinical characteristics and the risk of complications or nondiagnostic findings. Results: Of the 1,155 biopsies performed in a total of 965 patients procedural complications were identified in 24 patients (2.2%), including 5 (0.4%) with major complications (Clavien 3a or greater). No patients were identified with tumor seeding of the biopsy tract. Patient age, body mass index, gender, Charlson comorbidity index, smoking, mass diameter, nephrometry score, number of cores and prior biopsy were not associated with complication risk (p = 0.06 to 0.53). Complications were not increased for patients on aspirin or those with low platelets (25,000 to 160,000/μl blood) or a mildly elevated INR (international normalized ratio) (1.2 to 2.0, p = 0.16, 0.07 and 0.50, respectively). The complication risk was not increased during the initial 50 cases of a radiologist or when a trainee was present (p = 0.35 and 0.12, respectively). Nondiagnostic findings were present in 14.6% of biopsies. Independent predictors included cystic features, contrast enhancement, mass diameter and skin-to-mass distance (p <0.001, 0.002, 0.02 and 0.049, respectively). Radiologist experience was not associated with the nondiagnostic rate (p = 0.23). Prior nondiagnostic biopsy was not associated with an increased nondiagnostic rate on subsequent attempts (19.2% vs 14.2%, p = 0.23). Conclusions: Procedural complications following biopsy are rare even with low serum platelets, a mildly elevated INR or when the patient remains on aspirin. Cystic features, hypo-enhancement on imaging, a smaller mass diameter and a longer skin-to-tumor distance increase the risk of nondiagnostic findings. References 1. : Renal mass and localized renal cancer: AUA guideline. J Urol 2017; 198: 520. Link, Google Scholar 2. : Diagnostic accuracy and risks of biopsy in the diagnosis of a renal mass suspicious for localized renal cell carcinoma: systematic review of the literature. J Urol 2016; 195: 1340. 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Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the first of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1216 and 1217. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byUhlig A, Lenis A, Wang X and Shuch B (2021) Sequencing of Renal Mass Biopsy and Ablation: Results from the National Cancer DatabaseUrology Practice, VOL. 8, NO. 5, (555-564), Online publication date: 1-Sep-2021.Laguna M (2020) Re: Renal Mass Biopsy is Associated with Reduction in Surgery for Early-Stage Kidney CancerJournal of Urology, VOL. 203, NO. 5, (878-878), Online publication date: 1-May-2020.Related articlesJournal of Urology8 May 2019Editorial CommentJournal of Urology8 May 2019Editorial Comment Volume 201Issue 6June 2019Page: 1080-1087Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsaspirinrenal cellbiopsycarcinomakidney neoplasmshemorrhageMetricsAuthor Information Natasza M. Posielski Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Anthony Bui Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Shane A. Wells Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon. More articles by this author Sara L. Best Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Lori Mankowski Gettle Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Timothy J. Ziemlewicz Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon. More articles by this author Meghan G. Lubner Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Financial interest and/or other relationship with Ethicon and Philips. More articles by this author J. Louis Hinshaw Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Fred T. Lee Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Glenn O. Allen Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author Stephen Y. Nakada Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin More articles by this author E. Jason Abel Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin §Correspondence: Department of Urology, University of Wisconsin School of Medicine and Public Health, 1685 Highland Ave., Madison, Wisconsin 53705 (telephone: 920-740-3911; FAX: 608-263-4563; e-mail: E-mail Address: [email protected]). More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the first of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 1216 and 1217. Advertisement PDF downloadLoading ..." @default.
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