The Evaluation of Renal Tumor Diagnostics in Global Pathology Practice

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Yıldırım N.A.; Farid L.; Akbulut D.; Malik S.; Slisarenko M.; Baydar D.E.; Jikurashvili M.; Tjio E.; Koy Y.; Ertunc O.; Kuthi L.; Montasser A.; Galea L.; Lobo A.; Korentzelos D.; Lagarde-Lenon M.S.; Yaprak Bayrak B.; Biltekin B.; Cheng L.; Williamson S.R.; Sangoi A.R.; Akgul M.

Journal: International Journal of Surgical Pathology

Publisher: SAGE Publications Inc.

Publication Date: 29 June 2026

ISSN: 10668969

DOI: 10.1177/10668969261458406

Scopus: View on Scopus

PubMed: 42370741

Document Type: Article

Authors and Affiliations

Yıldırım N.A., Department of Pathology, Gulhane Research and Training Hospital, Ankara, Turkey; Farid L., Department of Pathology, Ain Shams University Hospital, Cairo, Egypt; Akbulut D., Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States; Malik S., Department of Pathology, Albany Medical Center, Albany, NY, United States; Slisarenko M., Department of Pathology, Medical Laboratory CSD LAB, Kyiv, Ukraine; Baydar D.E., Department of Pathology, Koç University School of Medicine, İstanbul, Turkey; Jikurashvili M., Department of Pathology, Tbilisi State Medical University, Tbilisi, Georgia; Tjio E., Histopathology Department, Harrogate District Hospital, Harrogate, United Kingdom; Koy Y., Department of Pathology, Health Sciences University Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey; Ertunc O., Department of Pathology, Gazi University School of Medicine, Ankara, Turkey; Kuthi L., Department of Surgical and Molecular Pathology, Tumor Pathology Center, National Institute of Oncology, Budapest, Hungary, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary, HUN-REN-ONKOL-TTK-HCEMM Oncogenomics Research Group, National Institute of Oncology, Budapest, Hungary; Montasser A., Department of Pathology, Theodor Bilharz Research Institute, Ministry of Higher Education and Scientific Research, Giza, Egypt; Galea L., Department of Anatomical Pathology, Melbourne Pathology, Sonic Healthcare, Melbourne, VIC, Australia; Lobo A., Department of Pathology, Kapoor Centre of Urology and Pathology, Raipur, India; Korentzelos D., Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States; Lagarde-Lenon M.S., Anatomic and Clinical Pathology, University of Santo Tomas Hospital, Manila, Philippines, Department of Pathology, National Kidney and Transplant Institute, Quezon City, Philippines; Yaprak Bayrak B., Department of Pathology, School of Medicine, Kocaeli University, Kocaeli, Turkey; Biltekin B., Department of Histology and Embryology, Atlas University School of Medicine, Istanbul, Turkey; Cheng L., Department of Pathology and Laboratory Medicine, Department of Surgery (Urology), Brown University Warren Alpert Medical School, The Legorreta Cancer Center at Brown University and Brown University Health, Providence, RI, United States; Williamson S.R., Department of Pathology and Laboratory Medicine, Cleveland Clinic Foundation, Cleveland, OH, United States; Sangoi A.R., Department of Pathology, Stanford University, Stanford, CA, United States; Akgul M., Department of Pathology, Atlas University School of Medicine, Istanbul, Turkey, Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States

Abstract

Background: The 2022 World Health Organization (WHO) fifth Edition introduced major revisions to renal neoplasm classification, incorporating novel and molecularly defined entities. However, the extent to which these advances are adopted in routine pathology practice remains unclear. This international survey evaluated the global diagnostic work-up of kidney tumors, including access to ancillary tests (immunohistochemistry [IHC], fluorescence in situ hybridization [FISH], next-generation sequencing [NGS]) and familiarity with the current classification. Methods: A 30-question online survey was distributed via SurveyMonkey to pathologists involved in renal tumor diagnostics between January and July 2024. The survey assessed demographics, practice setting, training background, WHO classification familiarity, and availability of IHC and molecular testing. Responses were analyzed using descriptive and inferential statistics. Results: Of 427 respondents, 399 (94.8%) reported encountering kidney tumors and were included, representing 45 countries. The most represented were the United States (18.8%), Egypt (15.8%), Turkey (12.6%), the United Kingdom (8.8%), and India (7.3%). Nearly half (49.4%) had >10 years of practice, 41.1% lacked formal genitourinary pathology training, and 70.7% worked in academic settings. IHC was widely available (96.0%), whereas access to FISH (50.1%) and NGS (43.8%) was limited. High-resource academic centers had significantly greater access to molecular diagnostics than community settings (all p < .001). Kidney-specific molecular panels were available in only 18.1% of institutions. Emerging biomarkers (SDHB, FH, cathepsin K, TFE3, TRIM63) were substantially less available than conventional markers. Although 66.3% reported familiarity with the WHO classification, 33.6% cited barriers such as rapid updates, financial constraints, and workload. Conclusions: Marked global disparities persist in renal tumor diagnostics. While IHC is widely accessible, advanced molecular tools and novel biomarkers remain unevenly distributed, underscoring the need for targeted educational and resource-sharing strategies. © The Author(s) 2026

Keywords

global pathology practice; renal tumors; WHO classification

Citation Information

Scopus Citations: 0

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