Andrew Dennis Smith MD, PhD, Presenter: Research Grant, Pfizer Inc Research Grant, Acumed LLC

Brian C. Allen MD, Abstract Co-Author: Nothing to Disclose

Rupan Sanyal MD, Abstract Co-Author: Nothing to Disclose

Jason Williams BS, Abstract Co-Author: Nothing to Disclose

Casey Shane Taylor MD, Abstract Co-Author: Nothing to Disclose

Haowei Zhang MD, PhD, Abstract Co-Author: Nothing to Disclose

The Bosniak classification system stratifies cystic renal lesions into groups based on imaging features and the associated risk of malignancy on surgical pathology. Our overall objective is to evaluate the rate of locally advanced and metastatic disease and survival in patients with BIIF, BIII and BIV lesions using a multi-institutional web-based data registry.

For this multi-institutional retrospective study, including data from the University of Mississippi Medical Center and Wake Forest Baptist Medical Center, a password-protected IRB-approved HIPAA-compliant REDCap web-based data registry containing 328 unique data fields was utilized and is expected to house data from 400+ patients (including data from the University of Alabama) when complete. Included patients were age >18years without Von Hippel Lindau disease and with definitive therapy or clinical follow up >1year. The database captures information on number of Bosniak lesions, date/imaging modality for diagnosis, duration of imaging/clinical follow up, type of diagnostic workup and management (imaging/clinical follow up, surgery, or ablation), patient comorbidities, risk factors for malignancy, reclassification of lesions, and complications/costs associated with management. Descriptive statistics were utilized for presentation of clinical outcome data.

63 BIIF, 63 BIII, and 10 BIV lesions in 110 patients were included in the study. 70/110 (64%) patients were managed by imaging/clinical follow up, 28/110 (25%) by surgery, and 12/110 (11%) by ablation. Patients managed with imaging/clinical follow up had 55 BIIF, 31 BIII and 3 BIV lesions with median 2 years (range 0 to 10 years) imaging surveillance and median 3 years (range 1 to 12 years) clinical follow up. Patients managed with surgery or ablation had 8 BIIF, 32 BIII and 7 BIV lesions with clinical follow up of median 3 years (range 0 to 12 years). 0/110 (0%) patients presented with or developed locally advanced or metastatic disease or death directly attributed to a Bosniak lesion.

There were no locally advanced or metastatic lesions and no deaths related to a Bosniak lesion in this preliminary analysis of a multi-institutional web-based data registry.

No locally advanced or metastatic disease or deaths from Bosniak cystic renal lesions have been reported in short-term follow up. Are we appropriately-treating all or over-treating some lesions?

Smith, A, Allen, B, Sanyal, R, Williams, J, Taylor, C, Zhang, H, No Locally Advanced Disease, Metastases or Deaths from Bosniak IIF, III or IV Cystic Renal Lesions, Preliminary Results from a Multi-institutional Retrospective Data Registry.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031530.html