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5 - Staging of renal cancer

Published online by Cambridge University Press:  08 August 2009

By
Giles Rottenberg  and
Sheila C. Rankin
Edited by
Uday Patel
Giles Rottenberg
Affiliation:
Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
Sheila C. Rankin
Affiliation:
Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
Uday Patel
Affiliation:
St George's Hospital, London
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Summary

Introduction: Why stage disease?

The staging of renal tumors is important as it divides them into groups that enable a logical framework for treatment planning, entry into clinical trials, and prognostication. With the increasing use of techniques such as nephron-sparing surgery and laparoscopic surgery the radiological staging information will determine the type of surgical approach. Also, unlike surgery which provides tissue for pathological staging, ablative therapies such as cryotherapy or radiofrequency ablation rely solely on radiological staging, with the occasional benefit of renal biopsy.

History of staging

The first staging system for renal tumors was introduced by Flocks and Kadesky in 1958 and subsequently modified by Robson in 1963. The TNM criteria was introduced in 1978 and revised in 1987, 1997, and most recently in 2002 (Table 5.1). These modifications reflected a change in surgical approach and better understanding of the survival characteristics of the different groups.

The 1997 AJCC (American Joint Committee on Cancer) revision resulted in reclassification of T1 lesions from confined tumors less than or equal to 2.5 cm to those lesions 7 cm or less. Confined tumors measuring greater than 7 cm were classified as T2. A subsequent study demonstrated an 83% 5-year survival for T1 tumors with a 57% 5-year survival for T2 tumors. This major difference in prognosis underlies the rationale for the division between T1 and T2 tumors.

Type
Chapter
Information
Carcinoma of the Kidney , pp. 91 - 111
Publisher: Cambridge University Press
Print publication year: 2007

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References

Robson, C. J., Churchill, B. M., and Anderson, W., The results of radical nephrectomy for renal cell carcinoma. AJCC, 101 (1969), 297–301.Google ScholarPubMed
Tsui, K. H., Shvarts, O., Smith, R. B.et al., Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised TNM staging criteria. J Urol, 163 (2000), 1090–5.CrossRefGoogle ScholarPubMed
Frank, I., Blute, M. L., Leibovich, B. C.et al., Independent validation of the 2002 American Joint Committee on cancer primary tumour classification for renal cell carcinoma using a large, single institution cohort. J Urol, 173:6 (2005), 1889–992.CrossRefGoogle ScholarPubMed
Frank, I., Blute, M. L., Leibovich, B. C.et al., pT2 classification for renal cell carcinoma. Can its accuracy be improved?J Urol, 173:2 (2005), 380–4.CrossRefGoogle ScholarPubMed
Marshall, F. F., Stewart, A. K., and Menck, H. R., National Cancer data base. Cancer, 80 (1997), 2167–74.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Hsu, R. M., Chan, D. Y., and Siegelman, S. S., Small renal carcinomas: correlation of size with tumour stage, nuclear grade and histological subtype. AJR Am J Roentgenol, 182:3 (2004), 551–7.CrossRefGoogle Scholar
Bechtold, R. E. and Zagoria, R. J., Imaging approach to staging of renal cell carcinoma. Urol Clin North Am, 24 (1997), 507–22.CrossRefGoogle ScholarPubMed
Johnson, C. D., Dunnick, N. R., and Cohan, R. H., Renal adenocarcinoma: CT staging of 100 tumours. AJR Am J Roentgenol, 148 (1987), 59–63.CrossRefGoogle Scholar
Roberts, W. W., Bhayani, S. B., Allaf, M. E.et al., Pathological stage does not alter the prognosis for renal lesions determined to be stage T1 by computerized tomography. J Urol, 173 (2005), 713–15.CrossRefGoogle Scholar
Ergin, F. B., Hussain, H. K., Caoili, E. M.et al., MRI for preoperative staging of renal cell carcinoma using the 1997 TNM classification: comparison with surgical and pathological staging. AJR Am J Roentgenol, 182 (2004), 217–25.CrossRefGoogle Scholar
Narumi, Y., Hricak, H., Presti, J. C. Jr.et al., MR imaging evaluation of renal cell carcinoma. Abdom Imag, 22:2 (1997), 216–25.CrossRefGoogle ScholarPubMed
Roy, C. Sr., Ghali, S. El, Buy, X.et al., Significance of the pseudocapsule on MRI of renal neoplasms and its potential application for local staging: a retrospective study. AJR Am J Roentgenol, 184 (2005), 113–20.CrossRefGoogle ScholarPubMed
Kallman, D. A., King, B. F., Hatery, R. R.et al., Renal vein and inferior vena cava tumour thrombus in renal cell carcinoma: CT, US MRI and venacavography. J Comput Assist Tomogr, 16:2 (1992), 240–7.CrossRefGoogle ScholarPubMed
Hallscheidt, P. J., Fink, C., Haferkamp, A.et al., Preoperative staging of renal cell carcinoma with inferior vena cava thrombus using multidetector CT and MRI: prospective study with histopathological correlation. JCAT, 29:1 (2005), 64–8.Google ScholarPubMed
Lawretschuk, N., Gani, J., Riordan, R., Esler, S., and Bolton, D. M., Multidetector computed tomography vs magnetic resonance imaging for defining the upper limit of renal cell carcinoma: a study and review. BJU Intl, 96 (2005), 291–5.CrossRefGoogle Scholar
Welch, T. J. and Roy, A. J., Helical and electron beam CT scanning in the evaluation of renal vein involvement in patients with renal cell carcinoma. J Comput Assist Tomogr, 21 (1997), 467–71.CrossRefGoogle Scholar
Oto, A., Herts, B. R., Remer, E. M.et al., Inferior vena cava tumor thrombus in renal cell carcinoma: staging by MR imaging and impact on surgical treatment. AJR Am J Roentgenol, 171 (1998), 1619–24.CrossRefGoogle ScholarPubMed
Sohaib, S. A., Teh, J., Nargund, V. H.et al., Assessment of tumour invasion of the vena caval wall in renal cell carcinoma cases by magnetic resonance imaging. J Urol, 167 (2002), 1271–5.CrossRefGoogle Scholar
Habboub, H. K., Abu-Yousef, M. M., Williams, R. D.et al., Accuracy of colour Doppler sonography in assessing venous thrombus extension in renal cell carcinoma. AJR Am J Roentgenol, 168 (1997), 267–71.CrossRefGoogle ScholarPubMed
Hricak, H., Thoeni, R. F., Carroll, P.et al., Adrenalectomy: defining its role in the surgical treatment of renal cell carcinoma. Urol Int, 71 (2003), 361–7.Google Scholar
Thrasher, J. B. and Paulson, D. F., Prognostic factors in renal cancer. Urol Clin North Am, 20 (1993), 247–61.Google ScholarPubMed
Struder, E. E., Scherz, S., and Scheidegger, J., Enlargement of regional lymph nodes in renal cell carcinoma is often not due to metastases. J Urol, 1 (1990), 243–5.CrossRefGoogle Scholar
Deserno, W. M., Harisinghani, M. G., Taupitz, M.et al., Urinary bladder cancer: preoperative nodal staging with ferumoxtran-10-enhanced MR imaging. Radiology, 233:2 (2004), 449–56.CrossRefGoogle ScholarPubMed
Harisinghani, M. G., Saksena, M. A., Hahn, P. F.et al., Ferumoxtran-10-enhanced MR lymphangiography: does contrast-enhanced imaging alone suffice for accurate lymph node characterization?AJR Am J Roentgenol, 186:1 (2006), 144–8.CrossRefGoogle ScholarPubMed
Phillips, C. K. and Taneja, S. S., The role of lymphadenopathy in the surgical management of renal cell carcinoma. Urol Oncol, 22:3 (2004), 214–23.CrossRefGoogle ScholarPubMed
Motzer, R. J., Bander, N. H., and Nanus, D. M., Medical progress: renal cell carcinoma. N Engl J Med, 335 (1996), 865–75.CrossRefGoogle Scholar
Chae, E. J., Kim, J. K., Kim, S. H.et al., Renal cell carcinoma: analysis of postoperative recurrence patterns. Radiology, 234:1 (2005), 189–96.CrossRefGoogle ScholarPubMed
Newmark, J. R., Newmark, G. M., Epstein, J. I.et al., Solitary late recurrence of renal cell carcinoma. Urology, 43 (1994), 725–8.CrossRefGoogle ScholarPubMed
Sagalowsky, A. I., Kadesky, K. T., Ewalt, D. M.et al., Factors influencing adrenal metastasis in renal cell carcinoma. J Urol, 151 (1994), 1181–4.CrossRefGoogle ScholarPubMed
Gill, I. S., McClennnan, B. L., Kerbl, K.et al., Adrenal involvement from renal cell carcinoma: predictive value of computerised tomography. J Urol, 152 (1994), 1082–5.CrossRefGoogle Scholar
Sio, M., Autorino, R., Lorenzo, G. Diet al., Adrenalectomy: defining its role in the surgical treatment of renal cell carcinoma. Urol Int, 71 (2003), 361–7.CrossRefGoogle ScholarPubMed
Honigschnabl, S., Gallo, S., Niederle, B.et al., How accurate is MR imaging in characterisation of adrenal masses: update of a long-term study. Eur J Radiol, 41 (2002), 113–22.CrossRefGoogle ScholarPubMed
Wahl, R. L., Harney, J., Hutchins, G.et al., Imaging of renal cancer using positron emission tomography with 2-deoxy-2-(18F)-fluoro-D-glucose: pilot animal and human studies. J Urol, 146 (1991), 1470–4.CrossRefGoogle ScholarPubMed
Bachor, R., Kotzerke, J., Gottfried, H. W.et al., Positron emission tomography in diagnosis of renal cell carcinoma. Urologe A, 35:2 (1996), 146–50.Google ScholarPubMed
Ramdave, S., Thomas, G. W., Berlangieri, S. U.et al., Clinical role of F-18 fluorodeoxyglucose positron emission tomography for detection and management of renal cell carcinoma. J Urol, 166 (2001), 825–30.CrossRefGoogle ScholarPubMed
Kang, D. E., White, R. L. Jr., Zuger, J. H.et al., Clinical use of fluorodeoxyglucose F 18 positron emission tomography for detection of renal cell carcinoma. J Urol, 171 (2004), 1806–9.CrossRefGoogle ScholarPubMed
Miyakita, H., Tokunaga, M., Onda, H.et al., Significance of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for detection of renal cell carcinoma and immunohistochemical glucose transporter 1 (GLUT-1) expression in the cancer. Int J Urol, 9 (2002), 15–18.CrossRefGoogle ScholarPubMed
Montravers, F., Grahek, D., Kerrou, K.et al., Evaluation of FDG uptake by renal malignancies (primary tumor or metastases) using a coincidence detection gamma camera. J Nucl Med, 41 (2000), 78–84.Google ScholarPubMed
Kumar, R., Chauhan, A., Lakhani, P.et al., 2-deoxy-2-(F-18)-fluoro-D-glucose positron emission tomography in characterization of solid renal masses. Mol Imaging Biol, 7 (2005), 431–9.CrossRefGoogle ScholarPubMed
Miyauchi, T., Brown, R. S., and Grossman, H. B., Correlation between visualization of primary renal cancer by F18-FDG-PET and histopathological findings. J Nucl Med, 37:Suppl (1996), 64P[abstract].Google Scholar
Majhail, N. S., Urbain, J. L., Albani, J. M.et al., F-18 fluorodeoxyglucose positron emission tomography in the evaluation of distant metastases from renal cell carcinoma. J Clin Oncol, 21:21 (2003), 3995–4000.CrossRefGoogle ScholarPubMed
Aide, N., Cappele, O., Bottet, P.et al., Efficiency of [(18)F]FDG PET in characterising renal cancer and detecting distant metastases: a comparison with CT. Eur J Nucl Med Mol Imaging, 30:9 (2003), 1236–45.CrossRefGoogle Scholar

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  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
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  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Staging of renal cancer
    • By Giles Rottenberg, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK, Sheila C. Rankin, Consultant, Radiologist, Radiology Department, Guy's and St. Thomas Foundation Trust, Guy's Hospital, London, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.007
Available formats
×