Systematic Review and Meta-analysis on Renal Tumor Biopsy: Accuracy, Safety, and Impact on Clinical Decision-making.
Georges Mjaess, Michele Nicolazzini, Daniele Amparore et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis assessed renal tumor biopsy (RTB) accuracy, safety, and clinical impact in studies of patients with renal masses. Across 103 studies, pooled diagnostic yield was 90%; sensitivity and specificity for malignancy were 99% and 85%, respectively. Biopsy findings showed high concordance with surgical pathology for benign versus malignant status and histological subtype, but only moderate concordance for tumor grade. Complications were uncommon, and RTB findings were associated with changes in clinical management in 39% of patients. Most included studies were retrospective and at high risk of bias.
Key findings
- Across 103 studies, pooled RTB diagnostic yield was 90%, with 99% sensitivity and 85% specificity for malignancy.
- Concordance with surgical pathology was 96% for benign versus malignant status and 89% for histological subtype; grade concordance was 64% using four tiers and 78% using two.
- The overall complication rate was 3%; Clavien-Dindo grade ≥3 complications were <1%, and bleeding events occurred in 1%.
- RTB findings were associated with a change in clinical management in 39% of patients and avoidance of active treatment in 28%.
Why it matters
Renal tumor biopsy may help distinguish benign from malignant lesions and clarify histological subtype, information that can support individualized decisions about management. Its performance is less reliable for tumor grade, so biopsy results should be interpreted with that uncertainty in mind. The low pooled complication rate is reassuring, although the evidence base has important methodological limitations.
What to keep in mind
Most studies were retrospective and at high risk of bias, particularly from patient selection and flow or timing.