Introduction

Renal mass biopsy (RMB) can be employed as an adjunct to the decision-making process for patients with small renal masses. It is hypothesized that the pathological diagnosis provided by RMB purports a QOL advantage by alleviating cancer-related uncertainty and anxiety. This study evaluates the influence of RMB on QOL in a large prospective registry of patients with SRM. _x000D_ _x000D_

Methods

The DISSRM (Delayed Intervention and Surveillance for Small Renal Masses) Registry is a multi-institutional study that prospectively follows patients with SRM who elect primary intervention (PI) or active surveillance (AS). Patients complete SF12 QOL questionnaire at enrollment, 6 and 12 months, and subsequently on an annual basis. SF12 scores, MCS (Mental Component Summary) and PCS (Physical Component Summary) were compared between patients who had RMB versus those who did not in the PI, AS, and crossover groups separately using ANOVA and linear regression mixed modeling.

Results

619 patients were identified in the DISSRM Registry, of whom 320 were in the AS arm and 299 in the PI arm. 84 patients (13.6%) underwent biopsy, 34 (40.6%) in the PI group, 35 (41.6%) in the AS group, and 15 (17.8%) in the AS group who crossed over. Median age, ECOG performance status and Charlson comorbidity Index (CCI) were similar regardless of biopsy status among the AS and PI groups. In PI patients, there were no significant differences between SF12, MCS or PCS (p>0.092) or changes in SF12, MCS, or PCS (p>0.162) in patients who underwent biopsy and those who did not across all time points up to 84 months. In the AS patients who did not crossover, no differences in SF12, MCS and PCS were seen between patients who had biopsy and those who did not (p>0.0564). PCS declined over time in patients who stayed on AS without biopsy (p<0.001), but all other measures were unchanged over time (p>0.7291). In the crossover group, SF12, MCS, and PCS were lower at 24 and 48 months in patients who had not undergone biopsy (p=0.002). These patients were older (72.5 vs 67.2, p=0.003), had higher CCI (p=0.004), and lower ECOG performance status (p=0.045). There were no changes to SF12, MCS, or PCS scores in crossover patients regardless of biopsy status over time (p>0.1513). _x000D_ _x000D_

Conclusions

AS and PI patients who underwent RMB during follow-up in DISSRM did not have significant changes in quality of life scores over time, nor did they have worse scores than their counterparts who did not undergo biopsy. A pathological diagnosis through RMB did not appear to have a beneficial or detrimental effect on QOL while on AS.

Funding

None