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Staging Renal Carcinoma: What Is Sufficient?

Staging Renal Carcinoma: What Is Sufficient? Abstract • We retrospectively reviewed the roentgenographic and pathologic staging of 64 patients with renal cell carcinoma to assess the role of the various staging modalities (ie, angiography, venacavography, bone scanning, ultrasound, computed tomography [CT], and magnetic resonance imaging). Specific attention was directed at detecting vena cava thrombus and metastatic bone disease, factors with a significant impact on the therapeutic approach. The findings support the role of CT as the principle tool for overall staging and the observation that venacavography is not indicated if CT has excluded caval thrombus. Similarly, routine bone scans are not warranted in the absence of an elevated alkaline phosphatase level or bone pain. The key to the more efficient utilization of imaging resources is understanding the capabilities of the technology available. (Arch Surg 1989;124:71-73) References 1. Cronan J, Feman R, Rosenfield A: Comparison of computerized tomography, ultrasound, and angiography in staging renal cell carcinoma . J Urol 1982;127:712-714. 2. Hricak H, Demas B, Williams R, et al: Magnetic resonance imaging in the diagnosis and staging of renal and perirenal neoplasms . Radiology 1985;154:709-715.Crossref 3. Richie J, Garnick M, Seltzer S, et al: Computerized tomography scan for diagnosis and staging of renal cell carcinoma . J Urol 1983;129:1114-1116. 4. Schefft P, Novick A, Straffon R, et al: Surgery for renal cell carcinoma extending into the inferior vena cava . J Urol 1978;120:28-31. 5. Webb J, Murray A, Bary P, et al: The accuracy and limitations of ultrasound in the assessment of venous extension in renal carcinoma . Br J Urol 1987;60:14-17.Crossref 6. Robson C, Churchill B, Anderson W: The results of nephrectomy for renal cell carcinoma . J Urol 1969;101:297. 7. Maldazys J, deKernion J: Current thoughts on the management of renal carcinoma . Am Urol Assoc Update Series 1985;28:2-7. 8. Bracken B, Jonsson K: How accurate is angiographic staging of renal cell carcinoma? Urology 1979;14:96-99.Crossref 9. Futter N, Collins J, Walsh W: Inaccuracies in angiographic staging of renal cell carcinoma . Urology 1979;14:629-630.Crossref 10. Jaschke W, vanKaik G, Peter S, et al: Accuracy of computed tomography in staging of kidney tumors . Acta Radiol 1982;25:593. 11. Sandler C, Raval B, David C: Computed tomography of the kidney . Urol Clin North Am 1985;12:657-676. 12. Choyke P, Kressel H, Pollack H, et al: Focal renal masses: Magnetic resonance imaging . Radiology 1984;152:471-477.Crossref 13. Lipuma J, Bryan P, Butler H, et al: Magnetic resonance imaging of the genitourinary tract . Urol Clin North Am 1986;12:531-550. 14. Blacher E, Johnson D, Haynie T: Value of routine radionuclide bone scans in renal cell carcinoma . Urology 1985;26:432-434.Crossref 15. Lindner A, Goldman D, deKernion J: Cost effective analysis of prenephrectomy radioisotope scans in renal cell carcinoma . Urology 1983;22:127-129.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Staging Renal Carcinoma: What Is Sufficient?

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Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410010081017
Publisher site
See Article on Publisher Site

Abstract

Abstract • We retrospectively reviewed the roentgenographic and pathologic staging of 64 patients with renal cell carcinoma to assess the role of the various staging modalities (ie, angiography, venacavography, bone scanning, ultrasound, computed tomography [CT], and magnetic resonance imaging). Specific attention was directed at detecting vena cava thrombus and metastatic bone disease, factors with a significant impact on the therapeutic approach. The findings support the role of CT as the principle tool for overall staging and the observation that venacavography is not indicated if CT has excluded caval thrombus. Similarly, routine bone scans are not warranted in the absence of an elevated alkaline phosphatase level or bone pain. The key to the more efficient utilization of imaging resources is understanding the capabilities of the technology available. (Arch Surg 1989;124:71-73) References 1. Cronan J, Feman R, Rosenfield A: Comparison of computerized tomography, ultrasound, and angiography in staging renal cell carcinoma . J Urol 1982;127:712-714. 2. Hricak H, Demas B, Williams R, et al: Magnetic resonance imaging in the diagnosis and staging of renal and perirenal neoplasms . Radiology 1985;154:709-715.Crossref 3. Richie J, Garnick M, Seltzer S, et al: Computerized tomography scan for diagnosis and staging of renal cell carcinoma . J Urol 1983;129:1114-1116. 4. Schefft P, Novick A, Straffon R, et al: Surgery for renal cell carcinoma extending into the inferior vena cava . J Urol 1978;120:28-31. 5. Webb J, Murray A, Bary P, et al: The accuracy and limitations of ultrasound in the assessment of venous extension in renal carcinoma . Br J Urol 1987;60:14-17.Crossref 6. Robson C, Churchill B, Anderson W: The results of nephrectomy for renal cell carcinoma . J Urol 1969;101:297. 7. Maldazys J, deKernion J: Current thoughts on the management of renal carcinoma . Am Urol Assoc Update Series 1985;28:2-7. 8. Bracken B, Jonsson K: How accurate is angiographic staging of renal cell carcinoma? Urology 1979;14:96-99.Crossref 9. Futter N, Collins J, Walsh W: Inaccuracies in angiographic staging of renal cell carcinoma . Urology 1979;14:629-630.Crossref 10. Jaschke W, vanKaik G, Peter S, et al: Accuracy of computed tomography in staging of kidney tumors . Acta Radiol 1982;25:593. 11. Sandler C, Raval B, David C: Computed tomography of the kidney . Urol Clin North Am 1985;12:657-676. 12. Choyke P, Kressel H, Pollack H, et al: Focal renal masses: Magnetic resonance imaging . Radiology 1984;152:471-477.Crossref 13. Lipuma J, Bryan P, Butler H, et al: Magnetic resonance imaging of the genitourinary tract . Urol Clin North Am 1986;12:531-550. 14. Blacher E, Johnson D, Haynie T: Value of routine radionuclide bone scans in renal cell carcinoma . Urology 1985;26:432-434.Crossref 15. Lindner A, Goldman D, deKernion J: Cost effective analysis of prenephrectomy radioisotope scans in renal cell carcinoma . Urology 1983;22:127-129.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1989

References