Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative
Background: Renal mass biopsy (RMB) has had limited and varied utilization to guide management of renal masses (RM). Objective: To evaluate utilization of RMB for newly diagnosed cT1 RMs across diverse practice types and assess associations of outcomes with RMB. Design, setting, and participants: MU...
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doaj-166074c16e7445fdbd447d00b188afba2021-07-15T04:28:32ZengElsevierEuropean Urology Open Science2666-16832021-08-01303743Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement CollaborativeAmit K. Patel0Brian R. Lane1Prateek Chintalapati2Lina Fouad3Mohit Butaney4Jeffrey Budzyn5Anna Johnson6Ji Qi7Edward Schervish8Craig G. Rogers9Henry Ford Health System, Detroit, MI, USA; Corresponding author. Vattikuti Urology Institute, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA.Michigan State University College of Human Medicine, Grand Rapids, MI, USA; Spectrum Health Hospital System, Grand Rapids, MI, USAWayne State School of Medicine, Detroit, MI, USAWayne State School of Medicine, Detroit, MI, USAHenry Ford Health System, Detroit, MI, USAHenry Ford Health System, Detroit, MI, USADepartment of Urology, University of Michigan Medical School, Ann Arbor, MI, USADepartment of Urology, University of Michigan Medical School, Ann Arbor, MI, USAMichigan Institute of Urology, Troy, MI, USAHenry Ford Health System, Detroit, MI, USABackground: Renal mass biopsy (RMB) has had limited and varied utilization to guide management of renal masses (RM). Objective: To evaluate utilization of RMB for newly diagnosed cT1 RMs across diverse practice types and assess associations of outcomes with RMB. Design, setting, and participants: MUSIC-KIDNEY commenced data collection in September 2017 for all newly presenting patients with a cT1 RM at 14 diverse practices. Patients were assessed at ≥120 d after initial evaluation. Outcome measurements and statistical analysis: Demographics and outcomes were compared for patients undergoing RMB versus no RMB. Clinical and demographic characteristics were summarized by RMB status using a χ2 test for categorical variables and Student t test for continuous variables. A mixed-effects logistic regression model was constructed to identify associations with RMB receipt. Results and limitations: RMB was performed in 15.5% (n = 282) of 1808 patients with a cT1 RM. Practice level rates varied from 0% to 100% (p = 0.001), with only five of 14 practices using RMB in >20% of patients. On multivariate analysis, predictors of RMB included greater comorbidity (Charlson comorbidity index ≥2 vs 0: odds ratio [OR] 1.44; p = 0.025) and solid lesion type (cystic vs solid: OR 0.17; p = 0.001; indeterminate vs solid: OR 0.58; p = 0.01). RMB patients were less likely to have benign pathology at intervention (5.0% vs 13.5%; p = 0.01). No radical nephrectomies were performed for patients with benign histology at RMB. The limitations include short follow-up and inclusion of practices with low numbers of RMBs. Conclusions: Utilization of RMB varied widely across practices. Factors associated with RMB include comorbidities and lesion type. Patients undergoing RMB were less likely to have benign histology at intervention. Patient summary: Current use of biopsy for kidney tumors is low and varies across our collaborative. Biopsy was performed in patients with greater comorbidity (more additional medical conditions) and for solid kidney tumors. Pretreatment biopsy is associated with lower nonmalignant pathology detected at treatment.http://www.sciencedirect.com/science/article/pii/S2666168321001063Renal mass biopsySmall renal massRenal cell carcinomaPartial nephrectomyPathology |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amit K. Patel Brian R. Lane Prateek Chintalapati Lina Fouad Mohit Butaney Jeffrey Budzyn Anna Johnson Ji Qi Edward Schervish Craig G. Rogers |
spellingShingle |
Amit K. Patel Brian R. Lane Prateek Chintalapati Lina Fouad Mohit Butaney Jeffrey Budzyn Anna Johnson Ji Qi Edward Schervish Craig G. Rogers Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative European Urology Open Science Renal mass biopsy Small renal mass Renal cell carcinoma Partial nephrectomy Pathology |
author_facet |
Amit K. Patel Brian R. Lane Prateek Chintalapati Lina Fouad Mohit Butaney Jeffrey Budzyn Anna Johnson Ji Qi Edward Schervish Craig G. Rogers |
author_sort |
Amit K. Patel |
title |
Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative |
title_short |
Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative |
title_full |
Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative |
title_fullStr |
Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative |
title_full_unstemmed |
Utilization of Renal Mass Biopsy for T1 Renal Lesions across Michigan: Results from MUSIC-KIDNEY, A Statewide Quality Improvement Collaborative |
title_sort |
utilization of renal mass biopsy for t1 renal lesions across michigan: results from music-kidney, a statewide quality improvement collaborative |
publisher |
Elsevier |
series |
European Urology Open Science |
issn |
2666-1683 |
publishDate |
2021-08-01 |
description |
Background: Renal mass biopsy (RMB) has had limited and varied utilization to guide management of renal masses (RM). Objective: To evaluate utilization of RMB for newly diagnosed cT1 RMs across diverse practice types and assess associations of outcomes with RMB. Design, setting, and participants: MUSIC-KIDNEY commenced data collection in September 2017 for all newly presenting patients with a cT1 RM at 14 diverse practices. Patients were assessed at ≥120 d after initial evaluation. Outcome measurements and statistical analysis: Demographics and outcomes were compared for patients undergoing RMB versus no RMB. Clinical and demographic characteristics were summarized by RMB status using a χ2 test for categorical variables and Student t test for continuous variables. A mixed-effects logistic regression model was constructed to identify associations with RMB receipt. Results and limitations: RMB was performed in 15.5% (n = 282) of 1808 patients with a cT1 RM. Practice level rates varied from 0% to 100% (p = 0.001), with only five of 14 practices using RMB in >20% of patients. On multivariate analysis, predictors of RMB included greater comorbidity (Charlson comorbidity index ≥2 vs 0: odds ratio [OR] 1.44; p = 0.025) and solid lesion type (cystic vs solid: OR 0.17; p = 0.001; indeterminate vs solid: OR 0.58; p = 0.01). RMB patients were less likely to have benign pathology at intervention (5.0% vs 13.5%; p = 0.01). No radical nephrectomies were performed for patients with benign histology at RMB. The limitations include short follow-up and inclusion of practices with low numbers of RMBs. Conclusions: Utilization of RMB varied widely across practices. Factors associated with RMB include comorbidities and lesion type. Patients undergoing RMB were less likely to have benign histology at intervention. Patient summary: Current use of biopsy for kidney tumors is low and varies across our collaborative. Biopsy was performed in patients with greater comorbidity (more additional medical conditions) and for solid kidney tumors. Pretreatment biopsy is associated with lower nonmalignant pathology detected at treatment. |
topic |
Renal mass biopsy Small renal mass Renal cell carcinoma Partial nephrectomy Pathology |
url |
http://www.sciencedirect.com/science/article/pii/S2666168321001063 |
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