Radiographic, Pathologic Renal Tumor Size Compared

There have been several studies and ongoing dialogue about renal tumors and the potential differences in their measurement by radiographic and/or pathologic means and the subsequent surgical decisions and results. The most recent information points, still, to fairly negligible degrees of variation and, now, better success in treatment overall.

The dimensions of renal tumors have been significant determiners for treatment types. Candidates for partial, open, laparoscopic or robotic nephrectomy and candidates for ablative therapies and active surveillance have been selected for each according to tumor size, as often measured in CT scans. And because the less invasive the treatment, the more preferable for the patient, size has been particularly important in treatment planning and follow through, with the goal of saving nephrons.

An article in Medical News Today outlined the recent findings from an abstract in UroToday by Sung Kyu Hong, MD, PhD, of the Kyung Hee University in Seoul. Although his study CT scans overestimated the sizes of tumors that were only in the 4 to < 5 cm range, the difference in actual size was only about 2 mm. “Previously, such phenomenon was mentioned as having clinical significance, since [the] 4 cm cutoff has long been applied for selection of candidates for partial nephrectomy,” Dr. Hong said. “The indication of partial nephrectomy is currently expanding, and recent reports have suggested that partial nephrectomy can be safely performed for tumors up to 7 cm,” making the slight variation in size measurement less of a factor in the decision between a more invasive or less invasive procedure.

Dr. Hong pointed out that his study was unusual in that CT scans were uniformly performed on all subjects within four weeks of surgery and were done by the same group of uroradiologists. The pathological reports were also consistently performed, according to time, technique and laboratory staff involvement.

Related seminar: CT/MRI of the Abdomen and Pelvis