Percutaneous Biopsy and Recurrence Risk in Stage 1 Renal Cancer: A Propensity Score-Matched Cohort Study

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Growing incidence of small renal tumors necessitates safe diagnostic methods.
• Percutaneous renal mass biopsy (RMB) adoption is limited by oncologic safety concerns.
• Lack of long-term outcome data hinders routine RMB use.

Purpose of the Study:

• Evaluate the impact of preoperative RMB on upstaging and recurrence in cT1 renal cell carcinoma (RCC) patients.
• Assess oncologic safety of RMB in patients undergoing definitive surgery.
• Provide long-term outcome data to inform clinical hesitation regarding RMB.

Main Methods:

• Retrospective cohort study comparing 386 patients with preoperative RMB to 772 propensity score-matched controls.
• Analysis of recurrence-free survival (RFS) using Kaplan-Meier and Cox regression.
• Evaluation of upstaging to perinephric fat invasion using multivariable logistic regression.

Main Results:

• No statistically significant difference in 5-year RFS between RMB and control groups (96.7% vs. 97.8%, p = 0.35).
• RMB was not associated with increased recurrence (HR = 0.71, p = 0.35) or upstaging (OR = 1.64, p = 0.182).
• Independent predictors of recurrence included tumor size, nuclear grade, high nephrometry E score, and perinephric fat invasion.

Conclusions:

• Preoperative RMB in T1 RCC is not associated with adverse oncologic outcomes.
• The findings affirm the safety of RMB for T1 renal cell carcinoma.
• Supports the utility of RMB in the management planning of small renal masses.