Background and objective: Renal tumour biopsy (RTB) can help in risk stratification
of renal tumours with implications for management, but its utilisation varies. Our
objective was to report current practice patterns, experiences, and perceptions of
RTB and research gaps regarding RTB for small renal masses (SRMs).
Methods: Two web-based surveys, one for health care providers (HCPs) and one for
patients, were distributed via the European Association of Urology Young Academic
Urologist Renal Cancer Working Group and the European Society of Residents in
Urology in January 2023.
Key findings and limitations: The HCP survey received 210 responses (response rate
51%) and the patient survey 54 responses (response rate 59%). A minority of HCPs
offer RTB to >50% of patients (14%), while 48% offer it in <10% of cases. Most HCPs
reported that RTB influences (61.5%) or sometimes influences (37.1%) management
decisions. Patients were more likely to favour active treatment if RTB showed highgrade cancer and less likely to favour active treatment for benign histology. HCPs
identified situations in which they would not favour RTB, such as cystic tumours and challenging anatomic locations. RTB availability (67%) and concerns about
delays to treatment (43%) were barriers to offering RTB. Priority research gaps
include a trial demonstrating that RTB leads to better clinical outcomes, and better
evidence that benign/indolent tumours do not require active treatment.
Conclusions and clinical implications: Utilisation of RTB for SRMs in Europe is low,
even though both HCPs and patients reported that RTB results can affect disease
management. Improving timely access to RTB and generating evidence on outcomes associated with RTB use are priorities for the kidney cancer community.
Patient summary: A biopsy of a kidney mass can help patients and doctors make
decisions on treatment, but our survey found that many patients in Europe are
not offered this option. Better access to biopsy services is needed, as well as more
research on what happens to patients after biopsy
