Urinary collecting system invasion on multiphasic CT in renal cell carcinomas: prevalence, characteristics, and clinical
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KIDNEYS, URETERS, BLADDER, RETROPERITONEUM
Urinary collecting system invasion on multiphasic CT in renal cell carcinomas: prevalence, characteristics, and clinical significance Atsushi Takamatsu1 · Kotaro Yoshida1 · Masaru Obokata2 · Dai Inoue1 · Norihide Yoneda1 · Yoshifumi Kadono3 · Satoshi Kobayashi4 · Toshifumi Gabata1 Received: 13 September 2020 / Revised: 13 September 2020 / Accepted: 5 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The aim of this study was to determine the prevalence of collecting system invasion (CSI) on multiphasic CT, validate the pathological findings, and investigate the relationship between CSI and clinical outcomes in patients with renal cell carcinomas (RCC). Methods Patients pathologically diagnosed with RCC between January 2008 and December 2017 were retrospectively enrolled in this study. They were divided into two groups according to the presence of CSI on multiphasic CT images. Patients’ clinical characteristics, radiological findings, and overall survival (OS) and recurrence-free survival (RFS) rates were analyzed and compared between the groups. In addition, the correlation of radiological findings with pathological findings was investigated. Results Among the included 347 kidneys of 340 patients, CSI was observed in 11 kidneys (3%; 95% confidence interval, 1.3–5.0%). In all the 11 kidneys, the tumors were pathologically diagnosed as clear cell RCC, and in one kidney, the tumor also had sarcomatoid features. When pathological CSI served as the standard of reference, the sensitivity, specificity, and accuracy of CSI on CT were 50%, 99.7%, and 97.1%, respectively. The OS and RFS rates were not significantly different between patients with CSI on CT and those without CSI. Conclusion This study found that the prevalence of RCC-related CSI was 3%. Because of the low prevalence, we cannot exclude the possibility that CSI on CT would be associated with the OS and RFS. Further studies are needed to determine whether CSI on CT can be an independent prognostic factor for survival in patients with RCC. Keywords Renal cell carcinoma · Renal pelvis · Ureter · Collecting system invasion Abbreviations AJCC American Joint Committee on Cancer CSI Collecting system invasion OS Overall survival
RCC Renal cell carcinoma RFS Recurrence-free survival TNM Tumor-node-metastasis UICC Union for International Cancer Control
* Kotaro Yoshida [email protected]‑u.ac.jp
Introduction
1
Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13‑1, Takaramachi, Kanazawa, Ishikawa 920‑8641, Japan
2
Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
3
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
4
Department of Quantum Medical Technology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
Renal cell carcinomas (RCC) are the most f
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