Introduction: The timing of renal mass biopsy during ablative treatment remains controversies. On one hand, biopsy performed simultaneous with the ablative procedure, in one setting reduce patient anxiety and financial burden. On the other hand the procedure is performed without histological evidence of malignancy and increase the risk of bleeding that may impair the ablative efficacy. In a staged procedure, with biopsy performed at a different timing before the ablation, the treatment is performed on a proven malignancy, but it requires two hospitalizations with increased cost and patient`s anxiety. At our institute until 2014, renal mass ablation performed simultaneous with the biopsies. Since 2014, the procedure is staged.
Purpose: The purpose of our work is to summarize our experience and to compare the two approaches.
Material and methods: From April 2012 to August 2016, 43 ablative procedures on renal masses were performed, in 41 patients (32 males, 9 females, average age 67, age range 47-89). At this work we included 38 patients who underwent both biopsy and ablation treatment, Group I: 16 patients – underwent simultaneous biopsy and ablation. Group II: 22 patients - underwent biopsy at a prior date before the ablation. At this period of time we performed 49 biopsies, 2 of them oncocytoma, 1 angiomyolipoma, 6 non-renal tumor (18%).
Results: Group I: one patient with post biopsy bleeding and ineffective ablation. Histological result: oncocytoma. Group II: one patient with post biopsy bleeding needed treatment with blood transfusion.
Conclusion: After more than 4 years of experience with thermal ablation we believe that there is advantage in dividing the biopsy and the ablation to separate dates. We perform ablation only on histologically proven tumor and by this preventing unnecessary invasive procedure.
