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How accurate is radiological imaging for perirenal fat and renal vein invasion in Renal Cell Carcinoma ?
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  • Oktay Ucer,
  • Talha Muezzinoglu,
  • Ender Ozden,
  • Guven Aslan,
  • Volkan Izol,
  • Yıldırım Bayazıt,
  • Mesut Altan,
  • Bulent Akdogan,
  • Haluk Ozen,
  • Sinan Sözen,
  • Serhat Çetin,
  • Evren Suer,
  • Baris Esen,
  • Sumer Baltacı
Oktay Ucer
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Talha Muezzinoglu
Celal Bayar University
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Ender Ozden
Ondokuz Mayıs Üniversitesi Tıp Fakültesi
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Guven Aslan
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Volkan Izol
Cukurova University Faculty of Medicine
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Yıldırım Bayazıt
Çukurova Üniversitesi Tıp Fakültesi
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Mesut Altan
Hacettepe University
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Bulent Akdogan
Hacettepe University
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Haluk Ozen
Hacettepe University
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Sinan Sözen
Gazi University
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Serhat Çetin
Gazi Üniversitesi Tıp Fakültesi
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Evren Suer
Ankara University Faculty of Medicine
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Baris Esen
Ankara University Faculty of Medicine
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Sumer Baltacı
Ankara University Faculty of Medicine
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Abstract

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 their disease.

Peer review status:ACCEPTED

27 Dec 2020Submitted to International Journal of Clinical Practice
28 Dec 2020Submission Checks Completed
28 Dec 2020Assigned to Editor
26 Apr 2021Reviewer(s) Assigned
02 May 2021Review(s) Completed, Editorial Evaluation Pending
04 May 20211st Revision Received
07 May 2021Submission Checks Completed
07 May 2021Assigned to Editor
07 May 2021Review(s) Completed, Editorial Evaluation Pending
07 May 2021Editorial Decision: Accept