Outcomes and complications related to the management of bosniak cystic renal lesions

Andrew Dennis Smith, Brian C. Allen, Rupan Sanyal, James Daniel Carson, Haowei Zhang, Jason Henry Williams, Clinton Collins, Michael Griswold, Xu Zhang

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The objective of our study was to evaluate outcomes and complications related to the management of Bosniak category IIF, III, and IV renal cysts. MATERIALS AND METHODS. For this multiinstitutional retrospective study, a Webbased Research Electronic Data Capture (REDCap) data registry was used to record data of 286 adult patients with 312 prospectively classified Bosniak IIF, III, and IV renal cysts diagnosed between January 2000 and October 2011. Included patients were managed by surgery (n = 86), percutaneous ablation (n = 19), or imaging surveillance of 1 year or more (n = 181). The median number of years of clinical surveillance was 2.4 years (range, 0-11.7 years), 2.6 years (range, 0.4-11.4 years), and 3.2 years (range, 1.1-11.6 years) for patients managed by surgery, ablation, and imaging surveillance, respectively. Pathologic and survival outcomes and complications related to management were evaluated. RESULTS. The malignancy rate at surgical pathology was 38% (3/8) for Bosniak IIF, 40% (29/72) for Bosniak III, and 90% (18/20) for Bosniak IV renal cysts. There were no metastases or deaths (0/144) directly related to Bosniak IIF renal cysts. There were no deaths (0/113) directly related to Bosniak III renal cysts, although one patient (1/113) developed local progression and lung metastases after thermal ablation. One patient with a Bosniak IV renal cyst (1/29) presented with and died of metastatic disease. Moderate to severe complications occurred in 19% (16/86), 5% (1/19), and 0% (0/181) of patients managed by surgery, ablation, and imaging surveillance, respectively (p

Original languageEnglish (US)
Pages (from-to)W550-W556
JournalAmerican Journal of Roentgenology
Volume204
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

Keywords

  • Bosniak
  • Cystic renal tumors
  • Renal cysts

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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    Smith, A. D., Allen, B. C., Sanyal, R., Carson, J. D., Zhang, H., Williams, J. H., Collins, C., Griswold, M., & Zhang, X. (2015). Outcomes and complications related to the management of bosniak cystic renal lesions. American Journal of Roentgenology, 204(5), W550-W556. https://doi.org/10.2214/AJR.14.13149