title: Should Small Renal Masses Be Biopsied?
abstract: Over the last few decades, the incidence of renal cell carcinomas (RCCs) has been steadily increasing. This is primarily due to an increase in detection of small renal masses (SRMs) as a result of widespread utilization of abdominal imaging. Interestingly, up to 30% of incidentally discovered SRMs (solid lesions measuring ≤4 cm) are benign, and consequently, the definitive treatment of all SRMs is associated with a considerable risk of overtreatment. To decrease the overtreatment rate, renal tumour biopsy (RTB) has been advocated as a safe alternative to identify the pretreatment histology of these SRMs. Although initially fraught with high non-diagnostic rates, more recent series from centres of experience have demonstrated that RTB is safe, reliable and accurate. The future of SRM management will combine pathological, molecular and genetic information to improve our ability to predict the behaviour of these lesions and herald risk-adapted personalized treatment.
authors.affiliation: Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Avenue, Suite 3-130, Toronto, Ontario, M5G 2M9, Canada. romaoleao@gmail.com.
authors.forename: Ricardo R N
authors.initials: RR
authors.lastname: Leão
authors.affiliation: Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, 610 University Avenue, Suite 3-130, Toronto, Ontario, M5G 2M9, Canada.
authors.forename: Ardalan E
authors.initials: AE
authors.lastname: Ahmad
authors.affiliation: Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke and the University of Sherbrooke, 3001-12ieme avenue Nord, Sherbrooke, Quebec, J1H 5N4, Canada.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Richard
mesh_terms: D001706:Biopsy / Q000009:adverse effects; D002292:Carcinoma, Renal Cell / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000069342:Medical Overuse; D009392:Nephrectomy
keywords: Renal biopsy; Renal cell carcinoma; Small renal mass