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

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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.

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Author information

Authors and Affiliations

  1. Department of Urology, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France

    François-Xavier Nouhaud

  2. Department of Urology, Bordeaux University Hospital, Bordeaux, France

    Jean-Christophe Bernhard

  3. Department of Urology, Angers University Hospital, Angers, France

    Pierre Bigot

  4. Department of Urology, Rennes University Hospital, Rennes, France

    Zine-Eddine Khene & Karim Bensalah

  5. Department of Urology, European Georges Pompidou Hospital, APHP, Paris, France

    François Audenet, Guillaume Fraisse & Arnaud Méjean

  6. Department of Urology, Strasbourg University Hospital, Strasbourg, France

    Herve Lang & Sebastien Bergerat

  7. Department of Radiology, Bordeaux University Hospital, Bordeaux, France

    Nicolas Grenier & François Cornelis

  8. Department of Radiology, Angers Urology Hospital, Angers, France

    Cosmina Nedelcu

  9. Department of Radiology, Rouen University Hospital, Rouen, France

    Sofiane Béjar

  10. Department of Pathology, Tours University Hospital, Tours, France

    Gaëlle Fromont-Hankard

  11. Department of Pathology, Henry Mondor University Hospital, APHP, Créteil, France

    Yves Allory

  12. Department of Pathology, Strasbourg University Hospital, Strasbourg, France

    Véronique Lindner

  13. Department of Pathology, European Georges Pompidou Hospital, APHP, Paris, France

    Virginie Verkarre

  14. Department of Pathology, Timone University Hospital, APHM, Marseille, France

    Laurent Daniel

  15. Department of Pathology, Bordeaux University Hospital, Bordeaux, France

    Mokrane Yacoub

  16. Department of Radiology, European Georges Pompidou Hospital, APHP, Paris, France

    Jean-Michel Correas

  17. Department of Pathology, Rennes University Hospital, Rennes, France

    Nathalie Rioux-Leclercq

Authors
  1. François-Xavier Nouhaud
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  2. Jean-Christophe Bernhard
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  3. Pierre Bigot
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  4. Zine-Eddine Khene
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  5. François Audenet
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  6. Herve Lang
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  7. Sebastien Bergerat
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  8. Guillaume Fraisse
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  9. Nicolas Grenier
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  10. François Cornelis
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  11. Cosmina Nedelcu
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  12. Sofiane Béjar
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  13. Gaëlle Fromont-Hankard
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  14. Yves Allory
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  15. Véronique Lindner
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  16. Virginie Verkarre
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  17. Laurent Daniel
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  18. Mokrane Yacoub
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  19. Jean-Michel Correas
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  20. Arnaud Méjean
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  21. Nathalie Rioux-Leclercq
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  22. Karim Bensalah
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Contributions

FXN: Project development, data collection, data analysis, manuscript writing. JCB: Project development, data collection, data analysis, manuscript writing. PB: Project development, data collection, manuscript writing. ZEK: Data collection. FA: Data collection. HL: Data collection. SB: Data collection. GF: Data collection. NG: Data collection. FC: Data collection. CN: Data collection. SB: Data collection. GF-H: Data collection. YA: Data collection. VL: Data collection. VV: Data collection. LD: Data collection. MY: Project development, data collection. JMC: Project development, data collection. AM: Project development, ,manuscript editing. NR-L: Project development, data analysis, manuscript editing. KB: Project development, data analysis, manuscript editing.

Corresponding author

Correspondence to François-Xavier Nouhaud.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval/statement of human rights

All procedures performed in this study were in accordance with the ethical standards of the institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. A signed informed consent form has been obtained for every patient before inclusion.

Additional information

From The French research network for kidney cancer (UroCCR) and The Oncology Committee of the French Urology Association (CCAFU).

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Nouhaud, FX., Bernhard, JC., Bigot, P. et al. Contemporary assessment of the correlation between Bosniak classification and histological characteristics of surgically removed atypical renal cysts (UroCCR-12 study). World J Urol 36, 1643–1649 (2018). https://doi.org/10.1007/s00345-018-2307-6

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  • DOI: https://doi.org/10.1007/s00345-018-2307-6

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