Objective:

In this study we aimed to present the data for patients followed-up and operated due to complex renal cysts using Bosniak classification system.

Method:

Data of all patients followed-up or underwent surgery via open / minimal invasive methods due to complex renal cysts in our clinic between 2016 and 2019 were retrospectively evaluated. Bosniak category IIF and higher lesions were included in the study.

Results:

A total of 83 patients were included in the study. The mean age of the patients was 52 ±10.1 years and 40 (48.2%) were male and 43 (51.8%) were female. Fifty-three (63.9%) patients had Bosniak IIF, 18 (21.7%) Bosniak III and 12 (14.5%) Bosniak IV lesions. Mean lesion size was 54±27.4 mm based on radiological evaluation. Surgery was performed in a total of 41 (49.4%) patients. Based on final pathology results, benign pathologies were detected in 13 (31.7%), clear cell renal cell carcinoma in 22 (53.7%), and papillary renal cell carcinoma in 6 (14.6%) patients. Malignancy rates were detected as 18.9%, 44.4% and 83.3% in Bosniak IIF, III and IV lesions , respectively. While the mean lesion size of the patients who had benign pathology was 64.6±18.4 mm, the mean lesion size of the patients with malign pathology was 58.3±29.7 mm (p = .41).

Conclusion:

Progression is an important finding of malignancy in Bosniak IIF lesions. An important amount of especially Bosniak III lesions are receiving unnecessary treatment. Thus, active surveillance is a treatment which should be considered in these patients. More comprehensive prospective randomized studies are needed.

Keywords: Bosniak classification, active surveillance, complex, renal cyst, renal surgery ÖZ Amaç: