1. Avoiding "Needless" nephrectomy: What is the role of small renal mass biopsy in 2024?
- Author
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Gao B, Gorgen ARH, Bhatt R, Tano ZE, Morgan KL, Vo K, Zarandi SS, Ali SN, Jiang P, Patel RM, Clayman RV, and Landman J
- Subjects
- Humans, Biopsy methods, Kidney pathology, Kidney surgery, Nephrectomy methods, Kidney Neoplasms surgery, Kidney Neoplasms pathology
- Abstract
Current guidelines do not mandate routine preoperative renal mass biopsy (RMB) for small renal masses (SRMs), which results in a considerable rate (18%-26%) of needless nephrectomy/partial nephrectomy for benign renal tumors. In light of this ongoing practice, a narrative review was conducted to examine the role of routine RMB for SRM. First, arguments justifying the current non-biopsy approach to SRM are critically reviewed and contested. Second, as a standalone procedure, RMB is critically assessed; RMB was found to have higher sensitivity, specificity, and an equal or lower complication rate when compared with other commonly preoperatively biopsied solid organ tumors (e.g., breast, prostate, lung, pancreas, thyroid, and liver). Based on the foregoing information, we propose a paradigm shift in SRM management, advocating for an updated policy in which partial nephrectomy or nephrectomy for SRM invariably occurs only after a preoperative biopsy confirms that a SRM is indeed malignant., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
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