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Relationship between Radiologic Tumor Size in renal cell carcinoma and pathological size

Year 2013, , 186 - 189, 01.12.2013
https://doi.org/10.5505/sakaryamj.2013.92485

Abstract

Objectives: Our goal was to stablish a ralation between radiologic tumor and patologic tumor in renal cell carcinoma cases.Methods: Radical nephrectomy or partial nephrectomy for renal tumor diagnosis of the 36 patients were evaluated retrospectively.The measure of before operation multi slice computed tomography (CT) of tumor size and real tumor size in pathologic specimens were compared. Patients categorized (TNM) in three groups: Tumor size less than 4cm labeled as T1a, Tumor size between 4 cm and 7 cm labeled as T1b and tumor size greater 7 cm labeled as T2.Results: Preoperative measured tumor dimensions by CT ranges between 2 cm and 14 cm (average 6.8 cm). Post-operative real pathologic tumor dimensions ranges between 2 cm and 14 cm (average 6.2 cm). For preoperative CT dimensions there were 4 patients in T1a phase, 8 patients in T1b phase and 20 patients in T2 phase. Patients numberes for T1a, T1b and T2 for post-operation pathologic dimensions of tumores have been changed to 5, 12 and 15 respectively.Conclusion: It was found that preoperative radiologic tumor dimensions were greater than real pathologic tumor dimensions. Medical treatment of renal cell cancer based on just radiologic tumor dimensions can decrease the chance of nefron sparing surgery of some patients.

References

  • Campbell SC, Novic A.C, Bukowski RM. Renal tumors. In: Wein A.J, Kavoussi LR, Novic A.C, et al. Campbell Walsh Urology. 9th ed. Philadelphia: WB Saunders; 2007. p. 1567-1637.
  • Jemal A, Siegel R, Xu J, Ward E Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277-300.
  • Robson CJ. Radical nephrectomy for renal cell carcinoma. J Urol 1963;89:37-42.
  • Uzzo RG, Novick AC. Nepron sparing surgery for renal tumors indications, techniques and outcoımes. J Urol 2001;166:6-18.
  • Butler BP, Novick AC, Miller DP, Campbell SA, Licht MR. Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology 1995;45:34-40.
  • Lerner SE, Hawkins CA, Blute ML, Grabner A, Wollan PC, Eickholt JT, et al. Disease outcome in patients with low stage renal cell carcinoma treated with nephron sparing or radical surgery. J Urol 1996;155(6):1868-1873.
  • Fergany A. Current status and advances in nephron-sparing surgery. Clin Genitourin Cancer 2006;5(1):26-33.
  • Reznek RH.CT/MRI in staging renal cell carcinoma. Cancer Imaging. 2004;14(4):25-32.
  • Godley PA, Stinchcombe TE. Renal Cell Carcinoma. Curr Opin Oncol 1999;11:213-217.
  • Leibovich BC, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol 2004;171(3):1066-1070.
  • Waalkes S, Becker F, Schrader AJ, Janssen M, Wegener G, Merseburger AS, et al. Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? Eur Urol. 2011;59(2):258-263.
  • Roberts WW, Bhayani SB, Allaf ME, Chan TY, Kavoussi LR, Jarrett TW. Pathological stage does not alter the prognosis for renal lesions determined to be stage T1 by computerized tomography. J Urol 2005;173:713-715
  • Guidelines on Renal carcinoma. European Association of Urology Guidelines. 2010
  • Ljungberg B. Nephron-Sparing Surgery Strategy: The Current Standard for the Treatment of Localised Renal Cell Carcinoma, Eur Urol 2011;10:49-51.
  • Nazim SM, Ather MH, Hafeez K, Salam B. Accuracy of multidetector CT scans in staging of renal carcinoma. Int J Surg. 2011;9(1):86-90.
  • Çağ Ç, Keskin D, Delibaş M, Killi R, Özyurt C, Nazlı O Böbrek tümörlerinde bilgisayarlı tomografiyle evrelemenin patolojik evreyle uyumluluğu Ege Tıp Dergisi 2000;39(2):117-120.
  • Türkvatan A, Akdur PO, Altinel M, Olçer T, Turhan N, Cumhur T, et al. Preoperative staging of renal cell carcinoma with multidetector CT. Diagn Interv Radiol. 2009;15(1):22-30
  • Catalano C, Fraioli F, Laghi A, Napoli A, Pediconi F, Danti M, et al. High-resolution multidetector CT in the preoperative evaluation of patients with renal cell carcinoma. AJR Am J Roentgenol. 2003;180(5):1271-1277.
  • Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844-853
  • Simmons Mn, Ching CB, Samplaski MK, Park CH, Gill IS. Kidney tumor location measurement using C index method. J Urol 2010;183:1708-1713
  • Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56:786- 793

Böbrek Hücreli Karsinomada Radyolojik tümör boyutu ile Patolojik boyutun ilişkisi

Year 2013, , 186 - 189, 01.12.2013
https://doi.org/10.5505/sakaryamj.2013.92485

Abstract

Amaç: Böbrek hücreli karsinom tedavisinde tümör boyutu cerrahi tipine karar vermede önemli yer tutar. Böbrek hücreli karsinom olgularında,radyolojik tümör boyutu ile patolojik tümör boyutunun ilişkilerinin ortaya konulmasını amaçladık.Gereç ve Yöntem: Böbrek tümörü tanısıyla radikal nefrektomi veya parsiyel nefrektomi uygulanan 36 olgu retrospektif olarak değerlendirildi. Patoloji sonucu böbrek hücreli kanser olmayan hastalar çalışma dışı bırakıldı. Operasyon öncesi çoklu dedektörlü bilgisayarlı tomografide (BT) ölçülen tümör boyutu ile postoperatif patoloji spesmenindeki gerçek tümör boyutu karşılaştırıldı. Hastalar TNM (2009) sistemine göre üç gruba ayrıldı. Hastalar T1a tümör boyutu 4 cm'den küçük, T1b 4 cm ile 7 cm arasında, T2 7 cm'den büyük olarak 3 grupta değerlendirildi.Bulgular: Preoperatif olarak BT ile ölçülen tümör boyutları 2 ile 14 cm arasında değişmektedir (ortalama 6.8 cm). Postoperatif olarak patolojik gerçek tümör boyutlarının 2 ile 14 cm arasında değişmektedir (ortalama 6,2 cm). Preoperatif BT boyutlarına göre T1a evresinde 4, T1b evresinde 8, T2 evresinde 20 hasta bulundu. Tümörlerin ameliyat sonrası patolojik boyutları değerlendirildiğinde T1a, T1b ve T2'deki hasta sayısı sırasıyla 5, 12 ve 15 olarak değişmiştir. BT ile 7 hasta olduğundan yüksek, 1 hasta düşük evrelenmiştir. BT ile preoperatif tümör evrelemesi % 75 oranında doğrulukla yapılmıştır.Sonuç: Preoperatif radyolojik tümör boyutu patolojik gerçek tümör boyutuna göre daha büyük olabilir.Sadece radyolojik tümör boyutuna bakılarak BHK'in tedavisine karar verilmesi bazı hastaların böbrek koruyucu tedavi şansını kaybetmelerine yol açabilir.

References

  • Campbell SC, Novic A.C, Bukowski RM. Renal tumors. In: Wein A.J, Kavoussi LR, Novic A.C, et al. Campbell Walsh Urology. 9th ed. Philadelphia: WB Saunders; 2007. p. 1567-1637.
  • Jemal A, Siegel R, Xu J, Ward E Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277-300.
  • Robson CJ. Radical nephrectomy for renal cell carcinoma. J Urol 1963;89:37-42.
  • Uzzo RG, Novick AC. Nepron sparing surgery for renal tumors indications, techniques and outcoımes. J Urol 2001;166:6-18.
  • Butler BP, Novick AC, Miller DP, Campbell SA, Licht MR. Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology 1995;45:34-40.
  • Lerner SE, Hawkins CA, Blute ML, Grabner A, Wollan PC, Eickholt JT, et al. Disease outcome in patients with low stage renal cell carcinoma treated with nephron sparing or radical surgery. J Urol 1996;155(6):1868-1873.
  • Fergany A. Current status and advances in nephron-sparing surgery. Clin Genitourin Cancer 2006;5(1):26-33.
  • Reznek RH.CT/MRI in staging renal cell carcinoma. Cancer Imaging. 2004;14(4):25-32.
  • Godley PA, Stinchcombe TE. Renal Cell Carcinoma. Curr Opin Oncol 1999;11:213-217.
  • Leibovich BC, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol 2004;171(3):1066-1070.
  • Waalkes S, Becker F, Schrader AJ, Janssen M, Wegener G, Merseburger AS, et al. Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? Eur Urol. 2011;59(2):258-263.
  • Roberts WW, Bhayani SB, Allaf ME, Chan TY, Kavoussi LR, Jarrett TW. Pathological stage does not alter the prognosis for renal lesions determined to be stage T1 by computerized tomography. J Urol 2005;173:713-715
  • Guidelines on Renal carcinoma. European Association of Urology Guidelines. 2010
  • Ljungberg B. Nephron-Sparing Surgery Strategy: The Current Standard for the Treatment of Localised Renal Cell Carcinoma, Eur Urol 2011;10:49-51.
  • Nazim SM, Ather MH, Hafeez K, Salam B. Accuracy of multidetector CT scans in staging of renal carcinoma. Int J Surg. 2011;9(1):86-90.
  • Çağ Ç, Keskin D, Delibaş M, Killi R, Özyurt C, Nazlı O Böbrek tümörlerinde bilgisayarlı tomografiyle evrelemenin patolojik evreyle uyumluluğu Ege Tıp Dergisi 2000;39(2):117-120.
  • Türkvatan A, Akdur PO, Altinel M, Olçer T, Turhan N, Cumhur T, et al. Preoperative staging of renal cell carcinoma with multidetector CT. Diagn Interv Radiol. 2009;15(1):22-30
  • Catalano C, Fraioli F, Laghi A, Napoli A, Pediconi F, Danti M, et al. High-resolution multidetector CT in the preoperative evaluation of patients with renal cell carcinoma. AJR Am J Roentgenol. 2003;180(5):1271-1277.
  • Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182:844-853
  • Simmons Mn, Ching CB, Samplaski MK, Park CH, Gill IS. Kidney tumor location measurement using C index method. J Urol 2010;183:1708-1713
  • Ficarra V, Novara G, Secco S, Macchi V, Porzionato A, De Caro R, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56:786- 793
There are 21 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Salih Budak This is me

Hasan Salih Sağlam This is me

Osman Köse This is me

Şükrü Kumsar This is me

Öztuğ Adsan This is me

Publication Date December 1, 2013
Submission Date September 7, 2015
Published in Issue Year 2013

Cite

AMA Budak S, Sağlam HS, Köse O, Kumsar Ş, Adsan Ö. Böbrek Hücreli Karsinomada Radyolojik tümör boyutu ile Patolojik boyutun ilişkisi. Sakarya Tıp Dergisi. December 2013;3(4):186-189. doi:10.5505/sakaryamj.2013.92485

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