The role of biopsy in small renal masses <4cm: A European Modified Delphi Consensus Statement.
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All Authors
Bernstein D.
Warren H.
Santiapillai J.
Fox G.
Wah T.
Campi R.
Bex A.
Barod R.
Gurusamy K.
Tran M.
LTHT Author
Wah, Tze Min
LTHT Department
Radiology
Non Medic
Publication Date
2024
Item Type
Conference Abstract
Language
Subject
BIOPSY , GUIDELINES AS TOPIC , KIDNEY NEOPLASMS , DELPHI TECHNIQUE
Subject Headings
Abstract
Introduction: Utilisation of diagnostic biopsy for small renal masses is variable across Europe. We worked with expert clinicians and patients to produce a consensus statement on the role of biopsy and to identify areas in which further research was required. Method(s): Interviews with clinicians and patients were performed to identify potential statements on the role of biopsy and research gaps. Subsequently, an expert multidisciplinary panel including patients and clinicians scored statements on a nine-point scale through a 3-stage webbased modified Delphi process, to assess consensus (<70% agreement). Panel members were provided with options to propose further statements for consideration after round one. A hybrid virtual / in-person moderation meeting was held to discuss statements where threshold of agreement was not met, before round 3. Result(s): 38 clinicians and 14 patients were involved in the statement, with 29 participants (76%) completing all three rounds of the process. 18 of 21 statements reached consensus. Recommendations included offering a biopsy before active treatment and offering a second attempt following a nondiagnostic biopsy, or if the characteristics of the renal mass changed on surveillance imaging. Additional recommendations included offering biopsy prior to starting on an active surveillance pathway and ensuring a biopsy service is available to all in need. Identified research gaps included a health economics assessment of biopsy and research evaluating how biopsy affects patient treatment choice and anxiety. Conclusion(s): This Delphi consensus statement, performed with clinicians and patients, provides insight into best-practice on renal tumour biopsy and priority areas for future research.
Journal
Journal of Clinical Urology