Staging of renal cell carcinoma

Abstract

As in other malignant tumors, prognosis in renal cell carcinoma (RCC) depends on tumor extent and metastasis at the time of primary diagnosis. Staging systems formalize the way in which the extent of RCC is being described and classified. Primary staging of RCC aims at evaluating surgical options. Since surgical excision, which is the mainstay of therapy in non-metastatic RCC, and, recently, minimally invasive ablation methods have evolved significantly over the last decades, staging systems continue to evolve along the way. The 40-year-old Robson classification has been replaced with the TNM classification of RCC, because the latter adapts more easily to changing patterns of diagnosis and therapy. Modern cross-sectional imaging methods, such as multidetector-row computed tomography (MDCT), and magnetic resonance imaging (MRI), perform highly in T-staging of local tumor extent and M-staging of distant metastasis. However, both MDCT and MRI perform poorly in N-staging of lymphadenopathy. At present, 18-F-desoxy-glucose positron emission tomography (FDG-PET) appears to be unreliable in the detection of RCC and its metastasis. This overview of current radiological and surgical literature attempts to describe how modern staging systems for RCC are organized, and which radiological and surgical developments currently influence the way in which primary staging and prognosis of RCC depend on one another.

Ovarian metastasis of clear cell renal cell carcinoma: A case report

“…The most significant prognostic factor determining the survival rate in RCC is the invasion into the renal vein or the inferior vena cava. 15 In our case, the renal tumour was not identified by ultrasound, but only by a transabdominal CT scan.…”

Recurrent renal cell carcinoma: clinical and prognostic value of FDG PET/CT

“…Despite their predominance in standard conventional imaging for accurate staging, at restaging, both ceCT and MRI have certain limitations [20]. As questions have been raised regarding the clinical value of FDG PET/CT, many authors have suggested a potential role for this method in the evaluation of recurrent RCC rather than in initial staging [14,15].…”

Preoperative staging of renal cell carcinoma using magnetic resonance imaging: comparison with pathological staging

“…Surgery is currently the only curative therapeutic approach to RCC, and accurate preoperative staging is mandatory for surgical planning and assessing prognosis that depends on the extent of the tumor and its metastasis at the time of its primary diagnosis as well as on other factors including the patient's age, general state of health, and comorbidities, which may influence life expectancy in general (6).…”