Diagnostic Yield of Renal Biopsy Immediately Prior to Laparoscopic Radiofrequency Ablation: A Multicenter Study

Abstract

In our multicenter experience, renal biopsy of 138 renal lesions at the time of laparoscopic RFA had a diagnostic yield of 94.2%. RCC was diagnosed in 68.8% of the patients, and in 73.1% of the conclusive biopsies.

The Role of Percutaneous Renal Biopsy in the Management of Small Renal Masses

“…Most studies investigating ablation utilize an immediate preablation biopsy; preablation biopsy demonstrates a high diagnostic yield of 94.2% [33]. The American Urological Association Guidelines for the Management of the Clinical Stage I Renal Mass [34••] strongly encourage percutaneous renal core biopsy in patients undergoing thermal ablation.…”

Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline

“…12 When non-diagnostic biopsies are discarded from analyses, sensitivity for core biopsy compared to fine needle aspiration is 99.5% v. 96.5% and specificity is 99.9% v. 98.9%, respectively. [13][14][15][16][17][18][19][20][21][22][23][24][25] Given the heterogeneity seen in any given tumor, grading a tumor on an aspirate or core biopsy has not been shown to be reliable. Furthermore, interpretation of biopsies following ablative therapy is difficult due to the often small number of tumor cells present and the postprocedural distortion of the growth pattern and renal architecture.…”

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“…Imaging does not always accurately differentiate benign from malignant disease [246]. Up to 25 % of small (< 3 cm) kidney lesions are benign [247], and as such, based on established oncologic standards, histological confirmation is necessary prior to treatment with a de-structive technique. This standard is not always followed.…”