Discrepancy between radiological and pathological size of renal masses

BMC Urology

Research Article

Norbert Douek¹  Ding Y Guo²  Manish I Patel³  Nicola N Jeffery⁴ 

[1] Campbelltown Hospital, Therry Rd, 2560, Campbelltown, NSW, Australia;Concord Hospital, Hospital Rd, 2139, Concord, NSW, Australia;Discipline of Surgery, University of Sydney, 2145, Westmead, NSW, Australia;Royal Prince Alfred Hospital, Missenden Rd, 2050, Camperdown, NSW, Australia;

关键词: Renal Cell Carcinoma;    Renal Tumor;    Partial Nephrectomy;    Radical Nephrectomy;    Papillary Renal Cell Carcinoma;   

DOI  :  10.1186/1471-2490-11-2

 received in 2010-07-18, accepted in 2011-02-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundTumor size is a critical variable in staging for renal cell carcinoma. Clinicians rely on radiological estimates of pathological tumor size to guide patient counseling regarding prognosis, choice of treatment strategy and entry into clinical trials. If there is a discrepancy between radiological and pathological measurements of renal tumor size, this could have implications for clinical practice. Our study aimed to compare the radiological size of solid renal tumors on computed tomography (CT) to the pathological size in an Australian population.MethodsWe identified 157 patients in the Westmead Renal Tumor Database, for whom data was available for both radiological tumor size on CT and pathological tumor size. The paired Student's t-test was used to compare the mean radiological tumor size and the mean pathological tumor size. Statistical significance was defined as P < 0.05. We also identified all cases in which post-operative down-staging or up-staging occurred due to discrepancy between radiological and pathological tumor sizes. Additionally, we examined the relationship between Fuhrman grade and radiological tumor size and pathological T stage.ResultsOverall, the mean radiological tumor size on CT was 58.3 mm and the mean pathological size was 55.2 mm. On average, CT overestimated pathological size by 3.1 mm (P = 0.012). CT overestimated pathological tumor size in 92 (58.6%) patients, underestimated in 44 (28.0%) patients and equaled pathological size in 21 (31.4%) patients. Among the 122 patients with pT1 or pT2 tumors, there was a discrepancy between clinical and pathological staging in 35 (29%) patients. Of these, 21 (17%) patients were down-staged post-operatively and 14 (11.5%) were up-staged. Fuhrman grade correlated positively with radiological tumor size (P = 0.039) and pathological tumor stage (P = 0.003).ConclusionsThere was a statistically significant but small difference (3.1 mm) between mean radiological and mean pathological tumor size, but this is of uncertain clinical significance. For some patients, the difference leads to a discrepancy between clinical and pathological staging, which may have implications for pre-operative patient counseling regarding prognosis and management.

【 授权许可】

Unknown   
© Jeffery et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.