Multi-institutional Evaluation of Upper Urinary Tract Biopsy Using Backloaded Cup Biopsy Forceps, a Nitinol Basket, and Standard Cup Biopsy Forceps

To compare the performance of 3 contemporary ureteroscopic biopsy devices for the histopathologic diagnosis of upper tract urothelial carcinoma (UTUC). We retrospectively reviewed 145 patients who underwent 182 urothelial biopsies using 2.4F backloaded cup biopsy forceps, a nitinol basket, or 3F sta...

Full description

Saved in:
Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2018-07, Vol.117, p.89-94
Main Authors: Lama, Daniel J., Safiullah, Shoaib, Patel, Roshan M., Lee, Thomas K., Balani, Jyoti P., Zhang, Lishi, Okhunov, Zhamshid, Margulis, Vitaly, Savage, Stephen J., Uchio, Edward, Landman, Jaime
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alloys
Biopsy - instrumentation
Biopsy - standards
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - surgery
Female
Humans
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Nephroureterectomy
Retrospective Studies
Surgical Instruments
Ureteral Neoplasms - pathology
Ureteral Neoplasms - surgery
Ureteroscopy - instrumentation
Urothelium - pathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To compare the performance of 3 contemporary ureteroscopic biopsy devices for the histopathologic diagnosis of upper tract urothelial carcinoma (UTUC). We retrospectively reviewed 145 patients who underwent 182 urothelial biopsies using 2.4F backloaded cup biopsy forceps, a nitinol basket, or 3F standard cup biopsy forceps at 3 tertiary academic centers between 2011 and 2016. Experienced genitourinary pathologists provided an assessment of each specimen without knowledge of the device used for biopsy. For patients who underwent nephroureterectomy without neoadjuvant chemotherapy within 3 months of biopsy-proven UTUC diagnosis, the biopsy grade was compared with both the grade and stage of the surgical specimen. Biopsy utilization varied among the 3 institutions (P .05) and was favored over standard cup forceps specimens. Grade concordance was not affected by specimen size (P >.05), morphology (P >.1), or location (P >.5). No difference existed among the devices in the rate of acquiring a grade concordant biopsy; however, the backloaded cup forceps provided concordant biopsies that could be distinguished as low- and high-grade (P = .02). The backloaded cup forceps and nitinol basket obtained a higher quality urothelial specimen compared with standard cup forceps. Ureteroscopic biopsy device selection did not significantly impact the accuracy of the histologic diagnosis of UTUC.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2018.03.040