A practical guide and decision-making protocol for the management of complex renal cystic masses

Objectives: To analyse the management, pathology and outcomes of complex renal cystic masses (CRCM) and to develop a decision-making tool for daily clinical care using the Bosniak classification system for CRCM. Patients and methods: A comprehensive dataset of 185 patients with 188 CRCM and a minimu...

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Autores principales:	Peter Weibl, Milan Hora, Boris Kollarik, Kristina Kalusova, Tomas Pitra, Mesut Remzi, Wilhelm Hübner, Pascal Balzer, Tobias Klatte
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2017
Materias:	Complex renal Bosniak classification Kidney cancer Renal cyst Surveillance Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/a4d67e9541df4272a9562f33f62dc412
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spelling	oai:doaj.org-article:a4d67e9541df4272a9562f33f62dc4122021-12-02T09:51:22ZA practical guide and decision-making protocol for the management of complex renal cystic masses2090-598X10.1016/j.aju.2017.02.001https://doaj.org/article/a4d67e9541df4272a9562f33f62dc4122017-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17300335https://doaj.org/toc/2090-598XObjectives: To analyse the management, pathology and outcomes of complex renal cystic masses (CRCM) and to develop a decision-making tool for daily clinical care using the Bosniak classification system for CRCM. Patients and methods: A comprehensive dataset of 185 patients with 188 CRCM and a minimum follow-up of 3 years were analysed for management, pathology and outcomes. Results: We analysed 35 Bosniak II, 34 Bosniak IIF, 58 Bosniak III, and 61 Bosniak IV lesions. The overall incidence of renal cell carcinoma was 8.6%, 29.4%, 62.1%, and 78.7% for each category. Based on our surveillance strategy of Bosniak IIF masses, we recommend computed tomography (CT)/magnetic resonance imaging (MRI) every 2 years after the initial examination. We also recommend performing one MRI (as an adjunct to CT) during the early follow-up period (<4 years). The use of MRI correlation for differential diagnostic purposes has proven useful for marginal Bosniak II, IIF and III cases. Conclusions: From our data, we have created a decision-making protocol to guide urologists in planning a safe and effective diagnostic and treatment strategy for CRCM. The Bosniak classification is a useful tool for clinical decision-making. Uncertainties still remain for Bosniak IIF and III lesions. Our protocol shows that individualised decision-making is necessary in a significant proportion of CRCM.Peter WeiblMilan HoraBoris KollarikKristina KalusovaTomas PitraMesut RemziWilhelm HübnerPascal BalzerTobias KlatteTaylor & Francis GrouparticleComplex renalBosniak classificationKidney cancerRenal cystSurveillanceDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 2, Pp 115-122 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Complex renal Bosniak classification Kidney cancer Renal cyst Surveillance Diseases of the genitourinary system. Urology RC870-923
spellingShingle	Complex renal Bosniak classification Kidney cancer Renal cyst Surveillance Diseases of the genitourinary system. Urology RC870-923 Peter Weibl Milan Hora Boris Kollarik Kristina Kalusova Tomas Pitra Mesut Remzi Wilhelm Hübner Pascal Balzer Tobias Klatte A practical guide and decision-making protocol for the management of complex renal cystic masses
description	Objectives: To analyse the management, pathology and outcomes of complex renal cystic masses (CRCM) and to develop a decision-making tool for daily clinical care using the Bosniak classification system for CRCM. Patients and methods: A comprehensive dataset of 185 patients with 188 CRCM and a minimum follow-up of 3 years were analysed for management, pathology and outcomes. Results: We analysed 35 Bosniak II, 34 Bosniak IIF, 58 Bosniak III, and 61 Bosniak IV lesions. The overall incidence of renal cell carcinoma was 8.6%, 29.4%, 62.1%, and 78.7% for each category. Based on our surveillance strategy of Bosniak IIF masses, we recommend computed tomography (CT)/magnetic resonance imaging (MRI) every 2 years after the initial examination. We also recommend performing one MRI (as an adjunct to CT) during the early follow-up period (<4 years). The use of MRI correlation for differential diagnostic purposes has proven useful for marginal Bosniak II, IIF and III cases. Conclusions: From our data, we have created a decision-making protocol to guide urologists in planning a safe and effective diagnostic and treatment strategy for CRCM. The Bosniak classification is a useful tool for clinical decision-making. Uncertainties still remain for Bosniak IIF and III lesions. Our protocol shows that individualised decision-making is necessary in a significant proportion of CRCM.
format	article
author	Peter Weibl Milan Hora Boris Kollarik Kristina Kalusova Tomas Pitra Mesut Remzi Wilhelm Hübner Pascal Balzer Tobias Klatte
author_facet	Peter Weibl Milan Hora Boris Kollarik Kristina Kalusova Tomas Pitra Mesut Remzi Wilhelm Hübner Pascal Balzer Tobias Klatte
author_sort	Peter Weibl
title	A practical guide and decision-making protocol for the management of complex renal cystic masses
title_short	A practical guide and decision-making protocol for the management of complex renal cystic masses
title_full	A practical guide and decision-making protocol for the management of complex renal cystic masses
title_fullStr	A practical guide and decision-making protocol for the management of complex renal cystic masses
title_full_unstemmed	A practical guide and decision-making protocol for the management of complex renal cystic masses
title_sort	practical guide and decision-making protocol for the management of complex renal cystic masses
publisher	Taylor & Francis Group
publishDate	2017
url	https://doaj.org/article/a4d67e9541df4272a9562f33f62dc412
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A practical guide and decision-making protocol for the management of complex renal cystic masses

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