Radiological Correlates of pT3a Kidney Cancer: Importance of Irregular Tumor Sinus Border

• DOI: 10.52733/kcj19n4-a1
• Publication Date: 2021-12-17T14:37:46Z
• Authors: Yunlin Ye; Diego Aguilar Pal...; Rebecca Campbell; Alain Rizk; Hajime Tanaka; Carlos Munoz-Lopez; Emily Abramczyk; Gustavo Roversi; Jianbo Li; Christopher Weight; Robert Abouassaly; Erick Remer; Steven Campbell
• Keywords: Renal vein; Renal sinus

Purpose: Preoperative assessment of T3a renal-cell-carcinoma (RCC) in absence main renal vein involvement or lymph node enlargement is challenging but has potential implications for counseling and prognosis. Materials Methods: A retrospective review 1129 cT1-T3aN0M0 RCC patients managed with partial/radical nephrectomy (PN/RN) our institution (2012-2014) was performed. Exclusion criteria included radiological evidence substantial lymphadenopathy. Eleven findings suggestive aggressive tumor biology invasive phenotype based on prior literature were assessed correlation pT3a status. These perinephric-findings (stranding, enhancing-nodule, collateral-vessels, irregular-perinephric-tumor-contour), within the sinus collecting-system invasion, branch-vein enlargement, irregular-tumor-sinus-border [ITSB]), tumor-necrosis, infiltrative-features, tumor-size. Radiological blinded to final pathology. Sensitivity/specificity logistic-regression analyses performance each imaging-finding detecting tumors. Results: Median tumor-size 4.0cm R.E.N.A.L. 8. follow-up 53 months (IQR:28-64). tumors found 281 (25%) strongly correlated local systemic recurrence (p<0.02). ITSB 350 (31%) strongest predictor Sensitivity/specificity/PPV/NPV/OR/C-Index 75%/84%/61%/91%/15.8(11.4-21.9)/0.80, pT3a, respectively. The best predictive model ITSB(yes/no) as a continuous variable (C-index=0.84). Addition other imaging-findings did not improve contributor all multivariable-models also recurrence-free-survival. Inter/intra-observer correlations 0.89/0.98, Conclusions: Our data suggest that associate RCC, which could impact patient counseling.