<b>MRI for Preoperative Staging of Renal Cell Carcinoma Using the 1997 TNM Classification:</b> Comparison with Surgical and Pathologic Staging

Ergen, Fatma Bilge; Hussain, Hero K.; Caoili, Elaine M.; Korobkin, Melvyn; Carlos, Ruth C.; Weadock, William J.; Johnson, Timothy D.; Shah, Rajal B.; Hayasaka, Satoru; Francis, Isaac R.

doi:10.2214/ajr.182.1.1820217

Cited by 70 publications

(42 citation statements)

References 32 publications

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“…An in vitro study on pathological validity of morcellated kidneys affected by renal tumors, including cases of perinephric fat invasion, revealed identical histology, grade, and stage when intact specimen evaluations were compared to a second analysis of the same specimens after morcellation (19). Additionally, advances in abdominal imaging tests (10,11), and mathematical models developed to guide pathologic sampling and analysis of morcellated specimens (12) can substantially increase the reliability of diagnosis and staging of renal malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…Specimen morcellation is associated with a smaller incision, better cosmesis, and fewer incisionrelated complications than open specimen extraction incisions (8,9), but is associated with a longer operative time with a controversial benefit in regard to pain control. Morcellating a specimen containing tumor is felt to make accurate pathologic staging more difficult, but this has not yet been proved to be clinically detrimental due to the development of better clinical staging due to higher resolution imaging tests (10,11), and the application of nomograms and standardized protocols for pathologic evaluation of fragmented specimens (12). The potential increased risk of tumor spill and port-site metastasis after morcellation has yet to be proven clinically significant (13,14).…”

Section: Introductionmentioning

confidence: 99%

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The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

et al. 2006

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Introduction:Compare the outcomes between kidney morcellation and two types of open specimen extraction incisions, several covariates need to be taken into consideration that have not yet been studied. Materials and Methods: We retrospectively reviewed 153 consecutive patients who underwent laparoscopic nephrectomy at our institution, 107 who underwent specimen morcellation and 46 with intact specimen removal, either those with connected port sites with a muscle-cutting incision and those with a remote, muscle-splitting incision. Operative time, postoperative analgesia requirements, and incisional complications were evaluated using univariate and multivariate analysis, comparing variables such as patient age, gender, body mass index (BMI), laterality, benign versus cancerous renal conditions, estimated blood loss, specimen weight, overall complications, and length of stay. Results: There was no significant difference for operative time between the 2 treatment groups (p = 0.65). Incision related complications occurred in 2 patients (4.4%) from the intact specimen group but none in the morcellation group (p = 0.03). Overall narcotic requirement was lower in patients with morcellated (41 mg) compared to intact specimen retrieval (66 mg) on univariate (p = 0.03) and multivariate analysis (p = 0.049). Upon further stratification, however, there was no significant difference in mean narcotic requirement between the morcellation and muscle-splitting incision subgroup (p = 0.14). Conclusion: Morcellation does not extend operative time, and is associated with significantly less postoperative pain compared to intact specimen retrieval overall, although this is not statistically significant if a remote, muscle-splitting incision is made. Morcellation markedly reduces the risk of incisional-related complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

et al. 2006

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“…The role of MRI has not been evaluated in large clinical series [29,46] . There is a poor agreement for N-staging between MRI and surgical pathological staging [47] .…”

Section: Response Assessmentmentioning

confidence: 99%

Imaging Studies in Metastatic Urogenital Cancer Patients Undergoing Systemic Therapy: Recommendations of a Multidisciplinary Consensus Meeting of the Association of Urological Oncology of the German Cancer Society

et al. 2010

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Introduction: Imaging studies are an integral and important diagnostic modality to stage, to monitor and follow-up patients with metastatic urogenital cancer. The currently available guidelines on diagnosis and treatment of urogenital cancer do not provide the clinician with evidence-based recommendations for daily practice. Objectives: To develop scientifically valid recommendations with regard to the most appropriate imaging technique and the most useful time interval in metastatic urogenital cancer patients undergoing systemic therapy. Methods: A systematic literature review was performed searching MedLine, Embase and Web of Science databases using the terms prostate, renal cell, bladder and testis cancer in combination with the variables lymph node, lung, liver, bone metastases, chemotherapy and molecular therapy, and the search terms computed tomography, magnetic resonance imaging and positron emission tomography were applied. A total of 11,834 records were retrieved from all databases. The panel reviewed the records to identify articles with the highest level of evidence using the recommendation of the US Agency for Health Care Policy and Research. Conclusions: Contrast-enhanced computed tomography remains the standard imaging technique for monitoring of pulmonary, hepatic and lymph node metastases. Bone scintigraphy is still the most widely used imaging technique for the detection and follow-up of osseous lesions. For clinical trials it might be replaced by either PET-CT or MRI of the skeletal axis. Response assessment for patients treated with cytotoxic regime is best performed by the RECIST/WHO criteria; treatment response to molecular triggered therapy is best assessed by CT evaluating decrease in tumor size and density. Cross-sectional imaging studies for response assessment might be obtained after each 2 cycles of systemic therapy to early stratify responders from non-responders.

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“…29 Transesophageal echocardiography, transabdominal colour flow Doppler ultrasonography or cavography have been used as complementary imaging modalities, when needed, to define the exact extent of renal vein or IVC involvement. 30 MRI is an accurate diagnostic tool for the delineation of the cephalad extent of the tumour thrombus; 29,31 however, recent data [32][33][34][35] suggest that multiplanar CT scan may approach the accuracy of MRI for identification and characterization of IVC thrombus. Although contrast venography is highly accurate, its invasive nature precludes its use; it is now reserved for the rare cases in which MRI or a CT scan would be contraindicated or equivocal.…”

Section: Mohammed Al Otaibi Md; Simon Tanguay MDmentioning

confidence: 99%

Locally advanced renal cell carcinoma

Otaibi

Tanguay

2012

CUAJ

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Despite the observed stage migration and earlier detection of renal masses, patients still present with locally advanced renal cell carcinoma. These patients represent a difficult oncologic challenge. Despite our ability to do surgical resectionto cure the disease, survival often remains limited. In this paper, we describethe role and indication for surgical resection for patients with enlarged retroperitoneallymph nodes, invasion of adjacent organs, invasion into the vena cavaor locally recurrent disease. The development of new strategies, including effective drugs to be used in association with surgical resection, will clearly be an essential step to further improve the outcome of these patients.

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MRI for Preoperative Staging of Renal Cell Carcinoma Using the 1997 TNM Classification: Comparison with Surgical and Pathologic Staging

Abstract: MRI is a reliable method for preoperative staging of renal cell carcinoma using the 1997 TNM classification, in particular for assessing venous involvement.

Cited by 70 publications

References 32 publications

The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

The effect of kidney morcellation on operative time, incision complications, and postoperative analgesia after laparoscopic nephrectomy

Imaging Studies in Metastatic Urogenital Cancer Patients Undergoing Systemic Therapy: Recommendations of a Multidisciplinary Consensus Meeting of the Association of Urological Oncology of the German Cancer Society

Locally advanced renal cell carcinoma

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