Abstract

ORTEGA HRESCAK, María Cinthya et al. Renal cell carcinoma: preoperative staging by computed tomography and its analogy to pathology. Rev. argent. radiol. [online]. 2013, vol.77, n.1, pp.11-17. ISSN 1852-9992.

Objective. To evaluate the correlation between the preoperative staging of renal cell carcinoma by computed tomography (CT) and histopathologic results of the surgical specimen. Materials and Methods. A retrospective study has been carried out in a total of 40 patients from our urology department with suspected diagnosis of renal cell carcinoma (RCC) who had undergone total or partial nephrectomy between 2005 and 2011. We compared different parameters of imaging (CT) and pathological studies of each patient and assessed the reciprocal relationship between pre-and postoperative staging according to TNM. Results. Data obtained by pathological examination of the resected specimen showed 28 lesions limited to the kidney (stages T1 and T2), 3 lesions with perirenal extension and renal vein (stage T3a), 7 lesions with involvement of the vena cava (stage T3b) and 2 lesions with extension beyond Gerota's fascia (stage T4). We found an almost perfect strength of agreement between tomographic and pathologic staging (kappa = 0.87), with respect to T of the TNM criteria. Only two T1b (by pathological study) were overdiagnosed as T2 (by computed tomography) and two T3b (by pathological study) were underdiagnosed as T3a (by CT). Conclusion. Computed tomography provides a good delineation and characterization of renal cell carcinoma. The level of agreement with the most reliable reference standard (pathological study) was almost perfect (k = 0.87) for the staging of T stage.

Keywords : Carcinoma; Renal cell; Mapping; Computed tomography; Pathological study.

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