Abstract
OBJECTIVE
To better understand the safety and diagnostic yield of percutaneous core-needle biopsy
(PCNB) for upper tract urothelial carcinoma (UTUC).
METHODS
Of 444 patients undergoing radical nephroureterectomy (RNU) for UTUC between 2009
and 2017 at our institution, 42 who had PCNB prior to RNU were identified for analysis.
Endpoints included safety, diagnostic yield, and concordance with RNU pathology. PCNB
specimens were deemed histologically concordant with RNU specimens for cases when
cytologic evaluation of biopsy specimen and corresponding pathologic evaluation of
RNU specimen both made a histologic diagnosis of urothelial carcinoma.
RESULTS
Median tumor size was 3.8 cm (1.2-10.2 cm). All lesions arose from the pelvicalyceal
system. CT-guidance was utilized in 52% (n = 22), and ultrasound-guidance in 48% (n = 20). Relative to RNU pathology, 95% of PCNBs demonstrated histologic concordance.
Histologic grade was provided in 69% (n = 29) of PCNBs, with a 90% (n = 26) concordance with surgical pathology. Grades 1-2 and 3 complications occurred
in 14.3% (n = 6) and 2.4% (n = 1), respectively. At a median follow-up of 28.2 months (range, 1.2-97.1 months)
after biopsy, no cases of radiographic tract seeding were identified.
CONCLUSION
In our cohort of 42 patients undergoing RNU for UTUC, PCNB appeared a safe diagnostic
tool with high histologic yield and grade concordance. With greater than 2 years of
follow-up, no cases of tract seeding were identified.
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Article info
Publication history
Published online: October 23, 2019
Accepted:
October 9,
2019
Received:
August 10,
2019
Footnotes
Funding: None.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
