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Inci MF, Kalayci TO, Tan S, Karasu S, Albayrak E, Cakir V, Ocal I, Ozkan F. Diagnostic value of strain elastography for differentiation between renal cell carcinoma and transitional cell carcinoma of kidney. Abdom Radiol (NY) 2016; 41:1152-9. [PMID: 26880174 DOI: 10.1007/s00261-016-0658-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The objective of our study was to prospectively evaluate the diagnostic performance of strain elastography for differentiation between renal cell carcinomas (RCCs) and transitional cell carcinomas (TCCs) of kidney. METHODS A total of 99 consecutive patients who were referred to our hospital because of a newly diagnosed solid renal mass suspicious for malignancy on radiological screenings were evaluated with sonography, including strain elastography. Strain elastography was used to compare the stiffness of the renal masses and renal cortex. The ratio of strain in a renal mass and nearby renal cortex was defined as the strain index value. Mean strain index values for RCCs and TCCs were compared, and mean strain index values between histological subtypes of RCC were also compared. RESULTS Although TCCs were smaller than RCCs (p < 0.001), there were no significant differences in gender distribution and mean age of the patients, and mean probe-tumor distance between RCC and TCC. The mean strain index value ±SD for TCC (5.18 ± 1.12) was significantly higher than the value for RCC (4.04 ± 0.72; p < 0.001). Mean strain index value for papillary cell carcinomas (4.09 ± 0.45) was slightly higher than that for clear cell carcinomas (3.85 ± 0.78): however, the difference was not statistically significant (p = 0.51). CONCLUSIONS Strain elastography can be used as a valuable imaging technique for preoperative differentiation between RCC and TCC of kidney.
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Affiliation(s)
- Mehmet Fatih Inci
- Department of Radiology, Izmir Katip Çelebi University, School of Medicine, Izmir, Turkey.
- Department of Radiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Polat Caddesi, Karabaglar, Izmir, 35160, Turkey.
| | - Tugce Ozlem Kalayci
- Department of Radiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Polat Caddesi, Karabaglar, Izmir, 35160, Turkey
| | - Sinan Tan
- Department of Radiology, Kırıkkale University, School of Medicine, Kırıkkale, Turkey
| | - Sebnem Karasu
- Department of Radiology, Atatürk Training and Research Hospital, Izmir Katip Celebi University, Polat Caddesi, Karabaglar, Izmir, 35160, Turkey
| | - Eda Albayrak
- Department of Radiology, Gaziosmanpasa University, School of Medicine, Tokat, Turkey
| | - Volkan Cakir
- Department of Radiology, Izmir Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Irfan Ocal
- Department of Pathology, Izmir Katip Çelebi University, School of Medicine, Izmir, Turkey
| | - Fuat Ozkan
- Department of Radiology, Okmeydanı Education and Research Hospital, Istanbul, Turkey
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Kang M, Kim HS, Jeong CW, Kwak C, Kim HH, Ku JH. Conditional Survival and Associated Prognostic Factors in Patients with Upper Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Retrospective Study at a Single Institution. Cancer Res Treat 2015; 48:621-31. [PMID: 26511817 PMCID: PMC4843715 DOI: 10.4143/crt.2015.220] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/21/2015] [Indexed: 01/05/2023] Open
Abstract
Purpose The purpose of this study is to evaluate the changes of conditional survival (CS) probabilities and to identify the prognostic parameters that significantly affect CS over time post-surgery in upper tract urothelial carcinoma (UTUC) patients. Materials and Methods A total of 330 patients were examined in the final analysis. Primary end point was conditional cancer-specific survival (CSS), overall survival (OS), and intravesical recurrence-free survival (IVRFS) after surgery. The Kaplan-Meier method was used for calculation of CS. Cox regression hazard ratio model was used to determine the predictors of CS. Results UTUC patients who had already survived 5 years after radical nephroureterectomy had a more favorable CS probability in all given survivorships compared to those with shorter survival times. Patients with unfavorable pathologic features showed a higher increment of 5-year conditional CSS and OS compared to their counterparts. For 5-year conditional CSS, several factors, including high-grade tumor, lymphovascular invasion, and tumor location showed significant association with risk elevation over time. Only age remained as a predictor of 5-year conditional OS with increased risk in all given survivorships. For 5-year IVRFS, no variables remained as significant predictive factors over time after surgery. Conclusion Our study provides valuable information for practical survival estimation and relevant prognostic factors for patients with UTUC after surgery.
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Affiliation(s)
- Minyong Kang
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyung Suk Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, Korea
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Bata P, Tarnoki DL, Tarnoki AD, Novak PK, Gyebnar J, Kekesi D, Szendroi A, Fejer B, Szasz AM, Nyirady P, Karlinger K, Berczi V. Transitional cell and clear cell renal carcinoma: differentiation of distinct histological types with multiphase CT. Acta Radiol 2014; 55:1112-9. [PMID: 24243889 DOI: 10.1177/0284185113510493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Transitional cell carcinoma (TCC) may mimic renal cell carcinoma (RCC) when it develops in a similar location, therefore, differentiation with imaging techniques might be challenging. Preoperative differentiation may have a significant role indicating the type of surgical treatment (nephrectomy vs. ureteronephrectomy). PURPOSE To retrospectively analyze the differences in the contrast enhancement of TCC and RCC. MATERIAL AND METHODS Images of 20 RCC and 12 TCC (mean ages, 62.3 ± 14.1 and 67.4 ± 12.0 years, respectively) were analyzed from patients who underwent multiphase computed tomography (CT) examinations following 1.5 mL/kg non-ionic contrast agent administration. Unenhanced corticomedullary (30-45 s), nephrographic (70-90 s), and excretory (300-480 s) phases were imaged. The attenuation characteristics of RCC and TCC were compared to the attenuation of the normal renal cortex. RESULTS Significant differences were found in the attenuation ratios between RCC or TCC in the corticomedullary (P = 0.040) and nephrographic (P = 0.004) phases using three regions of interest (ROIs) of 10 mm(2) size. If measuring ROIs comprising the complete tumor lesion instead of three small ROIs, no significant difference was observed in the attenuation ratios between RCC in TCC in any phases. CONCLUSION Our study reports significant attenuation differences between RCC and TCC in the corticomedullary and nephrographic phases by multiphase CT. The findings underscore the importance of multiphase CT in the differentiation of these two different entities. Using multiple small (three) ROIs is more accurate than measuring the whole tumor attenuation.
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Affiliation(s)
- Pal Bata
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - David Laszlo Tarnoki
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | | | - Pal Kaposi Novak
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Janos Gyebnar
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Dora Kekesi
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Attila Szendroi
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Bence Fejer
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - A Marcell Szasz
- Second Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Peter Nyirady
- Department of Urology, Semmelweis University, Budapest, Hungary
| | - Kinga Karlinger
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Viktor Berczi
- Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
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Marshall S, Stifelman M. Robot-assisted surgery for the treatment of upper urinary tract urothelial carcinoma. Urol Clin North Am 2014; 41:521-37. [PMID: 25306164 DOI: 10.1016/j.ucl.2014.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Robot-assisted laparoscopic surgery is increasingly used in urologic oncologic surgery. Robotic nephroureterectomy is still a relatively new technique. As upper tract urothelial carcinoma is a rare disease, intermediate- and long-term outcome data are scarce. However, robotic nephroureterectomy does seem to offer advantages to open and laparoscopic counterparts, with comparable short-term oncologic and functional outcomes. Here the authors review the robotic surgical management of upper tract urothelial carcinoma, with a review of the steps and tips on making this approach more widely adoptable.
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Affiliation(s)
- Susan Marshall
- Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, 2nd Floor, New York, NY 10016, USA.
| | - Michael Stifelman
- Department of Urology, NYU Langone Medical Center, 150 East 32nd Street, 2nd Floor, New York, NY 10016, USA
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Borghesi M, Brunocilla E, Schiavina R, Martorana G. Robot-Assisted Radical Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma: A Promising Alternative to Open Surgery or a Future “Gold Standard”? Clin Genitourin Cancer 2014; 12:e65-6. [DOI: 10.1016/j.clgc.2013.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 05/03/2013] [Indexed: 11/27/2022]
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Centrally Infiltrating Renal Masses on CT: Differentiating Intrarenal Transitional Cell Carcinoma From Centrally Located Renal Cell Carcinoma. AJR Am J Roentgenol 2012; 198:846-53. [DOI: 10.2214/ajr.11.7376] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Chromecki TF, Ehdaie B, Novara G, Pummer K, Zigeuner R, Seitz C, Pycha A, Lee RK, Cha EK, Karakiewicz PI, Ng C, Raman JD, Chun FK, Fritsche HM, Matsumoto K, Kassouf W, Walton TJ, Bastian PJ, Martínez-Salamanca JI, Scherr DS, Shariat SF. Chronological age is not an independent predictor of clinical outcomes after radical nephroureterectomy. World J Urol 2011; 29:473-80. [DOI: 10.1007/s00345-011-0677-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 04/01/2011] [Indexed: 11/29/2022] Open
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