How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?

Schlichter, A.; Schubert, Roberto; Werner, Wolfram; Zermann, Dirk-Hendrik; Schubert, Jörg

doi:10.1159/000030529

Cited by 27 publications

(11 citation statements)

References 23 publications

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“…In our study the rate was calculated as 1.6%. Our occult multifocality rate on preoperative imaging of 11.4% is consistent with those demonstrated by other researchers who reported a range of 3.5-13.1% [5,19] .…”

Section: Discussionsupporting

confidence: 92%

“…In our study, CT and ultrasonography detected 12.5% of multifocality among kidneys with multifocal tumors, preoperatively; this is consistent with published rates of 10-44% [2][3][4][5]19] . However, some researchers have failed to detect multifocality with either ultrasonography or CT [1,6] , while others report 94-95% detection rates using dual-phase helical CT or three-dimensional magnetic resonance imaging [20,21] .…”

Section: Discussionsupporting

confidence: 91%

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Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Sargin

Ekmekcioglu²,

Arpalı³

et al. 2009

Urol Int

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Introduction: The incidence of multifocality and associated clinicopathological factors in renal cell carcinoma were evaluated. Materials and Methods: Clinicopathological characteristics were assessed for 122 renal cell carcinoma-pathological specimens from 121 patients. Microscopic and gross tumor pathology, incidence of multifocality as well as association between tumor grade, histological subtype, stage, size and vascular involvement were assessed. Results: Multifocal renal cell carcinoma was diagnosed in 16 of 122 specimens (13.1%). Satellite lesions for 15 of 16 specimens displaying mulifocality had the same histological subtype as their primary tumor. The occult multifocality rate was 11.4%. Tumor grade and stage, but not size or volume, histological subtype, and vascular involvement were significantly related to multifocality. Conclusions: Accurate staging of renal cell carcinoma appears to be essential in determining whether a patient should undergo nephron-sparing surgery or radical nephrectomy. Patients with high stage and grade should receive the highest attention after nephron-sparing surgery. Larger studies are needed to further elucidate the association between clinicopathological factors and multifocality.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Sargin

Ekmekcioglu²,

Arpalı³

et al. 2009

Urol Int

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“…The relationship of multifocality and local recurrence is neither linear nor predictable [7]. Schlichter et al [18] reported that preoperative ultrasound and CT were able to detect multifocal tumors in only 22.9%. So, preoperative routine imaging cannot safely predict multifocal lesions of RCC.…”

Section: Discussionmentioning

confidence: 99%

Enucleoresection for the Elective Treatment of Small Renal Cell Carcinoma: Can It Be the Treatment of Choice?

Adamakis¹,

Koutalellis²,

Mitropoulos³

et al. 2007

Oncol Res Treat

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Background: We present our findings in a series of T1 renal cell carcinomas (RCC) treated with excision of the tumor surrounded by a minimal layer of grossly normal parenchyma. Patients and Methods: A total of 43 patients who underwent elective nephron-sparing surgery performed with enucleoresection were studied retrospectively. None of the patients had preoperative or intraoperative suspicion of positive nodes and were free from distant metastases before surgery (N0, M0). Patients status was last evaluated in January 2006. Results: Median age was 58.7 years (35-78). Median tumor size was 3.3 cm (1.5-7). There were no major complications such as bleeding and urinary leakage/ urinoma requiring re-operation. Pathological stage was pT1a in 38 (89%), pT1b in 4 (9%) and pT3a in 1 (2%) patient. Median followup was 32 months (6-89). A total of 5 patients with RCC had died as of January 2006. Overall, 3 (6.9%) patients had disease progression, of whom 2 (4.6%) were local recurrence, 1 alone and 1 associated with distant metastases. The overall cancer-specific survival was 95.4%, and the overall progression-free survival was 93%. Conclusions: Enucleoresection reproduces the results of partial and radical nephrectomy with minimal morbidity. It is a safe and acceptable approach for elective nephronsparing surgery.

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“…The careful examination of preoperative imaging is crucial to anticipate the potential difficulties of PN [4]. The anatomy, as depicted by cross-sectional imaging, is fragmented into multiple plain images referred to the different sections, projections and phases of the computed tomography (CT) scan.…”

Section: Introductionmentioning

confidence: 99%

Holographic Reconstructions for Preoperative Planning before Partial Nephrectomy: A Head-to-Head Comparison with Standard CT Scan

et al. 2018

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Background: Preoperative surgical planning before partial nephrectomy (PN) is a time-consuming and fragmentary process. Objectives: To evaluate the differences in the perception of renal anatomy between holographic reconstruction (HR) versus computed tomography (CT) in patients who are candidate to PN. Methods: CT scans of 10 consecutive patients with intermediate/high complexity renal masses (R.E.N.A.L. score > 8) scheduled for robot-assisted PN were translated into HR. Seven raters independently described how they interpreted several anatomical details from CT and HR respectively. The exams were presented unpaired and randomly. Inter-observer agreement and evaluation time were assessed. A questionnaire inquired clinical utility of CT and HR. Inter-observer agreement was measured by the Cohen’s kappa test. Evaluation time for CT and HR was compared by the Kruskal-Wallis test, overall and per rater. Examiners answered to the questionnaire following a Likert scale. Results: HR showed a higher inter-observer agreement, reaching a good level (k > 0.6) for almost all the anatomical details considered. Conversely, CT generally provided a fair or poor agreement (k < 0.6). The evaluation time was shorter for HR (mean 1.7 vs. 3.4 min, p < 0.0001). All raters declared that HR could facilitate preoperative planning before PN. Conclusions: HR can be useful for preoperative surgical planning before PN to ease the understanding of anatomy.

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How Accurate Is Diagnostic Imaging in Determination of Size and Multifocality of Renal Cell Carcinoma as a Prerequisite for Nephron-Sparing Surgery?

Cited by 27 publications

References 23 publications

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Multifocality Incidence and Accompanying Clinicopathological Factors in Renal Cell Carcinoma

Enucleoresection for the Elective Treatment of Small Renal Cell Carcinoma: Can It Be the Treatment of Choice?

Holographic Reconstructions for Preoperative Planning before Partial Nephrectomy: A Head-to-Head Comparison with Standard CT Scan

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