Introduction
Renal Cell Carcinoma (RCC) is the most frequent malignant tumor of the
kidney in adults and its incidence has been increasing globally (1).
Radical or partial nephrectomy is the standard surgical treatment of
RCC. Both the surgical procedure and approach are decided according to
the stage of cancer and the tumor features such as location, size and
centrality. Prognostic factors of RCC are classified into anatomical,
histological, clinical, and molecular by European Association of Urology
(EAU) Guidelines on RCC. The anatomical prognostic factors consist of
the criteria in the TNM classification system (2). Radiological
evaluation with computerized tomography (CT) and/or magnetic resonance
imaging (MRI) is used to characterize renal mass and its TNM stage. This
information is then used for treatment planning and patient counselling.
Multi-phasic contrast-enhanced CT of abdomen and chest is recommended
for the diagnosis and staging of RCC by EAU Guidelines on RCC. The
Guidelines also recommend MRI because of some advantages such as better
evaluation of venous involvement, avoidance of intravenous CT contrast
medium and reduction of radiation (2). CT staging for RCC has been
variably accurate, and staging inaccuracies, usually under-staging (most
common with Stage T3a disease) in previous studies has been reported
(3,4). Two large studies reported that patients upstaged from clinical
stage T1 to pathologic stage T3a RCC showed shorter survival outcomes
than those without upstaging (5,6). Therefore, accuracy of radiological
staging is very important for the management of patients with RCC. The
aim of the present study is to investigate the accuracy of radiological
staging of RCC in every stage and especially in pT3a cases.