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World J Urol. 2018 Oct;36(10):1643-1649. doi: 10.1007/s00345-018-2307-6. Epub 2018 May 5.

Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study).

Author information

1
Department of Urology, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. fx_nouhaud@hotmail.fr.
2
Department of Urology, Bordeaux University Hospital, Bordeaux, France.
3
Department of Urology, Angers University Hospital, Angers, France.
4
Department of Urology, Rennes University Hospital, Rennes, France.
5
Department of Urology, European Georges Pompidou Hospital, APHP, Paris, France.
6
Department of Urology, Strasbourg University Hospital, Strasbourg, France.
7
Department of Radiology, Bordeaux University Hospital, Bordeaux, France.
8
Department of Radiology, Angers Urology Hospital, Angers, France.
9
Department of Radiology, Rouen University Hospital, Rouen, France.
10
Department of Pathology, Tours University Hospital, Tours, France.
11
Department of Pathology, Henry Mondor University Hospital, APHP, Créteil, France.
12
Department of Pathology, Strasbourg University Hospital, Strasbourg, France.
13
Department of Pathology, European Georges Pompidou Hospital, APHP, Paris, France.
14
Department of Pathology, Timone University Hospital, APHM, Marseille, France.
15
Department of Pathology, Bordeaux University Hospital, Bordeaux, France.
16
Department of Radiology, European Georges Pompidou Hospital, APHP, Paris, France.
17
Department of Pathology, Rennes University Hospital, Rennes, France.

Abstract

PURPOSE:

To evaluate and compare pathological characteristics of renal cysts Bosniak IIF, III and IV in light of recent histological classification.

PATIENTS AND METHODS:

The French research network for kidney cancer UroCCR conducted a multicentre study on patients treated surgically for a renal cyst between 2007 and 2016. Independent radiological and centralized pathological reviews were performed for every patient. Pathological characteristics were compared to the Bosniak classification.

RESULTS:

Of a total 216 patients included, 175 (81.0%) tumours (90.9% of Bosniak IV, 69.8% of Bosniak III) were malignant or had a low malignant potential, with 60% of clear cell renal cell carcinoma (CCRCC), 24% of papillary RCC (PRCC) and 6.9% of multilocular cystic renal tumour of low malignant potential (MCRTLMP). Malignancies were mostly of low pT stage (86.4% of pT1-2), and low ISUP grade (68.0% of 1-2). Bosniak III cysts had a lower rate of CCRCC (46.7 vs. 67.3%), higher rate of PRCC (30 vs. 20.9%) and MCRTLMP (18.3 vs. 0.9%) compared to Bosniak IV (p < 0.001). Low-malignant potential lesions were less likely Bosniak IV and pT3-4 stage was more frequent in Bosniak IV vs. III (15.7 vs. 3.5%; p = 0.04). There were two recurrences (1.1%) and no cancer-related death occurred during follow-up.

CONCLUSION:

These results confirmed that cystic renal malignancies have excellent prognosis. Bosniak III cysts had a low malignant potential, which suggests surveillance could be an option for these lesions.

KEYWORDS:

Bosniak classification; Computed tomography; Histology; Low malignant potential; Renal cell carcinoma; Renal cysts

PMID:
29730837
DOI:
10.1007/s00345-018-2307-6
[Indexed for MEDLINE]

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