Role of Intraoperative US in the Decision for Radical or Partial Nephrectomy

Seçil, Mustafa; Elibol, Cenk; Aslan, Güven; Kefi, Aykut; Obuz, Funda; Tuna, Burçin; Yörükoğlu, Kutsal

doi:10.1148/radiol.10100859

Cited by 21 publications

(14 citation statements)

References 15 publications

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“…Recently, TNM staging has been updated and subgroups of T2 are defined according to the diameter of 7-10 cm for T2a and >10 cm for T2b (12). Tumor size is also a parameter that may alter the surgical approach as laparoscopic vs. open nephrectomy, or partial vs. radical nephrectomy (13)(14)(15). Because nephron sparing surgery is the main aim and has an increasing popularity in smaller tumors, the T1 cut-off value carries importance not only as a prognostic parameter but also as a parameter of treatment (13).…”

Section: Discussionmentioning

confidence: 99%

“…Tumor size is also a parameter that may alter the surgical approach as laparoscopic vs. open nephrectomy, or partial vs. radical nephrectomy (13)(14)(15). Because nephron sparing surgery is the main aim and has an increasing popularity in smaller tumors, the T1 cut-off value carries importance not only as a prognostic parameter but also as a parameter of treatment (13). Nephron sparing surgery for large tumors has also been suggested as a feasible method with acceptable pathological results despite prolonged operation times (14).…”

Section: Discussionmentioning

confidence: 99%

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The effect of tumor volume on survival in renal cell carcinoma patients

Seçil

Çullu²,

Aslan³

et al. 2012

Diagn Interv Radiol

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480R enal cell carcinoma (RCC) constitutes 85% of all primary malignant tumors arising from kidney and nearly 3% of adult cancers (1-6). Approximately 20%-30% of patients diagnosed with RCC have metastasis at the time of diagnosis (1). In patients with recurrent RCC, progression of the disease, the period of survival, and the disease process can be predicted owing to many morphological, clinical, histological, and molecular parameters (3). The prognostic markers of RCC include tumor node metastasis (TNM) stage as morphological marker; histological type, nuclear grade, tumor necrosis, and sarcomatoid change as histological markers; and factors such as adhesion molecules, molecules stimulating immune response, growth factor receptors, and molecules inducing hypoxia as molecular and genetic markers (3). Clinical and laboratory prognostic factors are represented by the following parameters: patient performance at tumor presentation, the erythrocyte sedimentation rate, thrombocyte count, as well as serum calcium, hemoglobin, and lactate dehydrogenase levels. Among these, tumor stage, grade, and patient performance are the most widely used. Many studies on molecular and cytogenetic markers have been performed but none has been found to be better than tumor stage and nuclear grade to estimate prognosis. For this reason, efforts for determining new prognostic factors that indicate the proliferation and progression of RCC still persist (2-4). Several trials have been conducted concerning the diameter of tumors in RCC; however, few trials exist regarding the tumor volume. Tumor volume calculated using three-dimensional (3D) imaging techniques is accepted as independent marker in predicting the outcome in pharyngolaryngeal, lung, and breast cancers (5). Tumor volume is the basic criterion for deciding the treatment outcome in radiotherapy (7). Measuring the volume of brain tumors allows making decision on the prognosis and treatment of the patient (8).The aim of our study was to investigate the effect of tumor volume on prognosis and the relation of tumor volume to other prognostic markers in patients with RCC. Materials and methodsThe study included 46 retrospectively assessed patients (32 males and 14 females; mean age, 58.13±10.47 years; age range, 33-81 years) who underwent surgery between January 2002 and January 2009 and received a diagnosis of RCC. Considering January 1, 2009 as the deadline, the clinical information and the last health status of all patients were obtained from the hospital information system and/or by contacting the patients or their relatives who agreed to communicate by phone. The study was approved by the local ethics committee of our institution. GENITOURINARY IMAGING ORIGINAL ARTICLE The effect of tumor volume on survival in patients with renal cell carcinomaMustafa Seçil, Neşat Çullu, Güven Aslan, Uğur Mungan, Fatma Uysal, Burçin Tuna, Kutsal Yörükoğlu MATERIALS AND METHODSThe study included 46 retrospectively assessed patients with RCC (32 males and 14 females; mean age, 58.13±10.47 years) ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of tumor volume on survival in renal cell carcinoma patients

Seçil

Çullu²,

Aslan³

et al. 2012

Diagn Interv Radiol

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“…The pyramids, calyces, infundibula, and the renal sinus fat are readily identified on intraoperative ultrasound and tumor involvement of these structures must be commented upon and relayed to the surgeon at the time the examination is being performed. The overall diagnostic accuracy of IOUS for detection of sinus invasion is 98%, and is superior to MRI, which ranged from 70% to 72% depending on the observer [25] . In addition, small new solid intrarenal tumors may be detected on IOUS, which have not been visualized on preoperative imaging, impacting patient management and the surgical approach ( Figure 6).…”

Section: Lesion Localizationmentioning

confidence: 99%

“…Its sensitivity, and specificity for detection of renal sinus invasion and venous invasion is very high, approaching 100% [25] . Centrally located renal masses abutting the renal hilar vessels, collecting system or renal pelvis may preclude a nephron-sparing procedure, since a negative margin may not be feasible [7,19,20,23] .…”

Section: Lesion Localizationmentioning

confidence: 99%

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Intraoperative abdominal ultrasound in oncologic imaging

Marcal

Patnana²,

Bhosale³

et al. 2013

WJR

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Significant advances in ultrasound technology have created new opportunities for its use in oncologic imaging. The advent of new transducers with focal beam technology and higher frequency has solidified the role of intraoperative sonography (IOUS) as an invaluable imaging modality in oncologic surgery of the liver, kidneys and pancreas. The ability to detect and characterize small lesions and the precise intraoperative localization of such tumors is essential for adequate surgical planning in segmental or lobar hepatic resections, metastasectomy, nephron-sparing surgery, and partial pancreatectomy. Also, diagnostic characterization of small equivocal lesions deemed indeterminate by conventional preoperative imaging such as multidetector computed tomography or magnetic resonance imaging, has become an important application of IOUS. This article will review the current applications of IOUS in the liver, kidneys and pancreas.

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