538 THE IMPLICATIONS OF INDETERMINATE PULMONARY NODULES ON STAGING CT IMAGING IN NEWLY DIAGNOSED RENAL CANCER

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging1 Apr 2011538 THE IMPLICATIONS OF INDETERMINATE PULMONARY NODULES ON STAGING CT IMAGING IN NEWLY DIAGNOSED RENAL CANCER David Black, Rhana Zakri, Dan Mcgrill, Vinay Kalsi, and Neil Barber David BlackDavid Black Frimley, United Kingdom More articles by this author , Rhana ZakriRhana Zakri Frimley, United Kingdom More articles by this author , Dan McgrillDan Mcgrill Frimley, United Kingdom More articles by this author , Vinay KalsiVinay Kalsi Frimley, United Kingdom More articles by this author , and Neil BarberNeil Barber Frimley, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1262AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Computed tomography (CT) scans of the chest and abdomen are routinely used for staging renal tumours before proceeding to treatment. These often reveal size indeterminate pulmonary nodules (IPN) (<1cm) which may or may not represent metastatic disease. Understanding the likely nature of these lesions may help to better advise patients regarding prognosis and treatment pathway. METHODS We examined the staging CT, pathology and outcome from prospectively collected data of a single surgeon's series of 184 patients treated surgically for renal cell carcinoma over a 5 year period. RESULTS 157 patients had staging CT scans and reports available. 47 (30%) of these had IPN on initial scan. 9 of these have yet to have follow up scans. Of the remaining 38 patients, in 8 (21%) cases the nodules progressed to more obviously represent metastatic disease over a mean period of 20 months (1–60), all had a renal tumour size of >6cm, representing 35% of those patients with >6cm primary renal lesions. No patients with primary tumours of <6cm showed progression of indeterminate nodules. CONCLUSIONS Indeterminate pulmonary nodules are a common finding in RCC staging CT. Here, with up to 5 year follow-up, 21% were found to represent metastatic disease and were exclusively found in patients where the primary renal tumour was >6cm. Our results would indicate that patients with >6cm renal tumours and indeterminate nodules on staging imaging have a 35% chance of these lesions representing metastatic disease. This finding should be considered when discussing further management of these patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e218 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Black Frimley, United Kingdom More articles by this author Rhana Zakri Frimley, United Kingdom More articles by this author Dan Mcgrill Frimley, United Kingdom More articles by this author Vinay Kalsi Frimley, United Kingdom More articles by this author Neil Barber Frimley, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...