Login to Access Video or Poster Abstract: MP22-09
Sources of Funding: None

Introduction

The utility of renal mass biopsies (RMB) in the diagnosis and management of kidney tumors remains debatable. We assessed the patients and urologists preferences in this regard.

Methods

Seventy-three patients diagnosed with renal tumors and 59 board-certified urologists were asked to participate in an interview-based study. Decision analysis was quantified using the standard gamble method to determine the minimal accepted accuracy (MAA) at which RMB would be favored as part of the diagnostic process. Clinical and demographic data with potential to affect participants preferences were analyzed.

Results

At the time of study interview, 56 patients (77%) were referred for kidney surgery and 17 (23%) opted for surveillance. Overall, 59% of the patients were willing to accept some level of inaccuracy (1-20%), whereas 41% would refute a biopsy irrespective of their designated treatment. Anxiety associated with the possibility of missing cancer was the primary determinant (70%) for declining RMB among patients referred for surgery while fear of biopsy-associated complications was the primary reason (58%) to decline RMB among those undergoing surveillance. Having an academic degree was associated with acceptance of a lower accuracy threshold (p=0.03). Of the 59 participating urologists, 39% were reluctant to recommend RMB, primarily because of its inexorable non-diagnostic rate.

Conclusions

Most patients and urologists would favor a RMB to facilitate their definitive treatment decision. Diagnostic accuracy of 95% was acceptable by the majority of study participants. The utility of RMB as part of the diagnostic algorithm for renal tumors should be discussed with patients, emphasizing its potential benefits and limitations.

Funding

None