Clinicopathological and radiological significance of the collateral vessels of renal cell carcinoma on preoperative computed tomography

Abstract

This study aimed to investigate the clinicopathological and radiological significance of the collateral vessel of renal cell carcinoma (RCC) on preoperative computed tomography (CT). Preoperative contrast-enhanced CT of 236 consecutive patients with pathological documented RCC were retrospectively reviewed during the period of 2014. The associations of the presence of collateral vessels with perioperative clinicopathological and radiological features, as well as long term survival outcomes were analyzed. Totally, collateral vessels were detected by contrast-enhanced CT in 110 of 236 patients. The presence of collateral vessels was significantly associated with higher pathologic T stage, higher Fuhrman grade, higher overall RENAL scores, greater tumor size and enhancement, and more tumor necrosis (all P < 0.05). In patients with clear cell RCC, those harboring collateral vessels had significantly higher SSIGN scores (P < 0.001) and shorter overall survival (P = 0.01) than those without collateral vessel. The incidence of intraoperative blood loss, blood transfusion, radical nephrectomy (RN) and open surgery were also significantly higher in patients with collateral vessels (all P < 0.05). In multivariate analysis, the presence of collateral vessels was significantly associated with RN (P = 0.021) and open surgery (P = 0.012). The presence of collateral vessels was significantly associated with aggressive clinicopathological parameters and worse prognosis. It is worth paying attention to its association with the choice of RN and open surgery in clinical practice.

Comparison of Perioperative Outcomes Between Laparoscopic and Open Partial Nephrectomy for Different Complexity Renal Cell Carcinoma Based on the R.E.N.A.L. Nephrometry Score

“… 4 Basing on quality-of-life and oncological outcomes, localized cT1 carcinomas are best treated through nephron-sparing surgery (NSS) rather than RN. 5 , 6 The American Urological Association and European Association of Urology claim NSS as the operation of choice when feasible. 7 , 8 The average estimated blood loss of the laparoscopic approach was universally lower open approach, but warm ischemia time (WIT) was longer.…”

CT features based preoperative predictors of aggressive pathology for clinical T1 solid renal cell carcinoma and the development of nomogram model

“…Peritumoral neovascularity was not routinely reported by radiologists, but it may have potential predictive value. Recently, Yanagi et al reported that peritumoral neovascularity was a significant factor associated with tumor recurrence in patients with small renal masses, and Suo et al found that RCC patients with peritumoral neovascularity had higher pT stage, nuclear grade, and shorter OS [ 20 , 35 ]. There is increasing evidence that the high level of peritumoral angiogenesis is associated with aggressiveness of RCC and our study confirmed that peritumoral neovascularity could be interpreted as a predictor of aggressiveness [ 36 ].…”