Predictive Imaging Features in Renal Cell Carcinoma
Condition: Renal Malignant Tumor
MeSH terms: Carcinoma; Carcinoma, Renal Cell
Study type: Observational

Summary: 
      The investigators aimed to evaluate the role of some findings that can be detected in
      preoperative radiological imaging of kidney masses in predicting locally advanced disease.
    

Detailed description: 
      Renal cell carcinoma (RCC) is one of the most common urinary system cancers and accounts for
      3% of all cancers. With the frequent use of imaging methods most renal masses are detected
      localized. The standard treatment option in localized RCC is radical nephrectomy (RN) or
      nephron-sparing surgery (NSS). NSS is preferred when appropriate in patients with tumor stage
      1 (T1) and has been shown to be comparable to RN in terms of oncologic outcomes. Although
      there is no prospective randomized study comparing NSS with RN in terms of oncological and
      renal functions in T2 patients, there are retrospective studies conducted to date. According
      to the current European urology guideline, the standard approach in patients with T2 and
      above is RN. Pre-operative clinical staging is performed with computed tomography (CT) or
      magnetic resonance imaging (MRI), and patients may develop local recurrence despite surgical
      procedures based on clinical stage. Pre-operative the patient and in the management of local
      disease. In clinical practice, pre-operative CT and MRI provide information about tumor size,
      tumor localization, presence of tumor invasion into vascular structures and adjacent organs.
      However, apart from these frequently reported findings, there are CT and MRI findings that
      can be used to predict advanced disease. In the 2017 Tumor, node, metastasis (TNM)
      classification, invasion of the pelvicalyceal system, perirenal or renal sinus fat invasion
      has been included in the T3a category. There are studies evaluating predictive value of CT to
      indicate renal sinus fat or perirenal fat invasion. Although not in the standard TNM
      classification, it has been shown that renal capsule invasion is an independent prognostic
      variable for advanced disease and can be detected on CT. On the other hand, it has been
      indicated that thickening of the Gerota's fascia, the presence of enlarged collateral
      vessels, and the presence of intra-tumoral necrosis may be imaging findings that can be used
      to predict advanced disease. The investigators think that the markers evaluated so far in
      pre-operative imaging and some additional markers may predict advanced disease in RCC. The
      investigators also think that the predictive value of MRI may be higher than CT. Therefore,
      in this study the investigators evaluated some predictive features (Renal capsule invasion,
      perirenal fat invasion, thickening of the Gerota's fascia, presence of enlarged collateral
      vessels, tumor necrosis, perinephric stranding) of pre-operative computed tomography and
      magnetic resonance imaging for advanced disease in renal cell carcinoma.
    

Intervention name(s): No intervention will be applied.
Intervention type(s): Other
Intervention description(s): The preoperative imaging of the participants, who were grouped according to the postoperative pathology results, will be examined.
Observational model: Other
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Patients aged 20-80 years who have a renal mass detected by CT or MR imaging in the urology
        outpatient clinic and undergo partial or radical nephrectomy.
      
Keywords: Renal Cell Carcinoma; Tomography; Magnetic resonance imaging