How accurate is radiological imaging for perirenal fat and renal vein
invasion in Renal Cell Carcinoma ?
Objective: To evaluate the accuracy of radiological staging, especially
renal venous and perirenal fat invasion, in renal cell carcinoma (RCC).
Material & Methods: Data of 4823 renal tumor patients from Renal Tumor
Database of Association of Uro-oncology in Turkey were evaluated. Of
4823 patients, 3309 RCC patients had complete radiological and
histopathological data were included to this study. The Pearson
Chi-squared test (χ2) was used to compare radiological and
histopathological stages. Results: The mean (SD) age of 3309 patients
was 58 (12.3). Preoperative radiological imaging was performed using
computed tomography (CT) (n=2510, 75.8%) or magnetic resonance imaging
(MRI) (n=799, 24.2%). There was a substantial concordance between
radiological and pathological staging (к=0.52, p<0.001).
Sensitivities of radiological staging in stage I, II, III and IV were
90.7%, 67.3%, 27.7% and 64.2%, respectively. The sensitivity in
stage III was lower than the other stages. Sub-analysis of stage IIIa
cases revealed that, for perirenal fat invasion and renal vein invasion,
sensitivity values were 15.4% and 11.3%, respectively. Conclusions:
There was a substantial concordance between radiological (CT and/or MRI)
and pathological T staging in RCC. However, this is not true for T3
cases. Sensitivity of preoperative radiological imaging in patients with
pT3a tumors is insufficient and lower than the other stages.
Consequently, preoperative imaging in patients with T3 RCC has to be
improved, in order to better inform the patients regarding prognosis of