To better understand their opinions on renal mass biopsy, a survey was given to urologists in the Pennsylvania Urologic Regional Collaborative and the Michigan Urological Surgery Improvement Collaborative. Renal mass biopsy (RMB) use varies significantly, yet it may minimize therapy of benign renal neoplasms.
Two quality improvement collaboratives, including members from academic and community-based settings, are the Pennsylvania Urologic Regional Collaborative and the Michigan Urological Surgery Improvement Collaborative. A 12-item survey was sent out to participants to analyze the current RMB use, patient- and tumor-specific characteristics, adverse events, the management impact, and simulated patient scenarios. Descriptive statistics were used to report the responses.
A large number of respondents (n=54) reported utilizing RMB in fewer than 25% of cT1a (59%) and cT1b (85%) tumors. The likelihood of metastasis to the kidney (94%), the patient’s comorbidities as a risk factor for active therapy (89%), and the patient’s age (81%) were the most important patient-specific determinants of the decision to suggest RMB. The existence of bilateral tumors (81%), tumor size (70%), and the likelihood of undergoing nephron-sparing surgery (67%) were the most significant tumor-specific variables. Ten respondents (19%) mentioned obstacles to RMB in their practice, 23 (43%) recalled instances of problems or poor results, and 43 (80%) cited instances where the consequences of RMB changed management. Few urologists (9% to -20%) advocated RMB in younger patients with any size mass when they were shown as simulated patients. Age, comorbidities, and tumor size were all considered while making recommendations.
Before beginning attempts to increase quality, it is crucial to comprehend viewpoints on using RMB. Rarely do the majority of urologists taking part in two statewide collaboratives recommend RMB. Increasing RMB efficiency might help cut down on wasteful procedures.
Reference: goldjournal.net/article/S0090-4295(22)00093-0/fulltext
