Bosniak Category IIF Designation and Surgery for Complex Renal Cysts
- 30 September 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 182 (3), 1091-1095
- https://doi.org/10.1016/j.juro.2009.05.046
Abstract
We investigated whether adding the IIF categorization improved the accuracy of Bosniak renal cyst classification, as evidenced by a low rate of progression in IIF lesions and a high rate of malignancy in category III lesions. We retrospectively reviewed the records of patients with complex renal cysts categorized as a Bosniak IIF or III. Surveillance imaging and pathological outcomes of category IIF cysts were recorded to determine radiological predictors of progression. Pathological outcomes of category III cysts were recorded to determine the malignancy rate. A total of 112 patients met study inclusion criteria, of whom 81 were initially diagnosed with a category IIF cyst and 31 had a Bosniak category III cyst. At a median followup of 15 months 14.8% of Bosniak IIF lesions progressed in complexity with a median time to progression of 11 months (maximum greater than 4 years). There were no differences in tumor or patient characteristics between cysts that progressed and those that remained stable. In the 33 patients with Bosniak III lesions who underwent surgical extirpation the malignancy rate was 81.8%. Most patients had low stage, low grade disease and remained recurrence-free at a median followup of 6 months. Adding the IIF category has increased the accuracy and clinical impact of the Bosniak categorization system, as evidenced by a low rate of progression in category IIF cysts and an increased rate of malignancy in surgically treated category III lesions compared to those in historical controls.Keywords
This publication has 9 references indexed in Scilit:
- An update of the Bosniak renal cyst classification systemUrology, 2005
- MR imaging of cystic renal massesMagnetic Resonance Imaging Clinics of North America, 2004
- Follow-Up CT of Moderately Complex Cystic Lesions of the Kidney (Bosniak Category IIF)American Journal of Roentgenology, 2003
- Cystic Renal MassesAmerican Journal of Roentgenology, 2000
- Diagnosis and management of patients with complicated cystic lesions of the kidney.American Journal of Roentgenology, 1997
- CT of cystic renal masses: analysis of diagnostic performance and interobserver variation.American Journal of Roentgenology, 1997
- Cystic renal masses: A reevaluation of the usefulness of the Bosniak classification systemAcademic Radiology, 1996
- Cystic renal masses: Usefulness of the bosniak classificationUrologic Radiology, 1991
- The current radiological approach to renal cysts.Radiology, 1986