You have accessJournal of UrologyKidney Cancer: Evaluation & Staging (II)1 Apr 2013743 CONCORDANCE BETWEEN CLINICAL AND PATHOLOGICAL LYMPH NODE INVASION IN RENAL CELL CARCINOMA Umberto Capitanio, Rayan Matloob, Fabio Castiglione, Paolo Capogrosso, Andrea Russo, Cristina Carenzi, La Croce Giovanni, Paolo Dell'Oglio, Andrea Gallina, Alberto Briganti, Francesco Montorsi, and Roberto Bertini Umberto CapitanioUmberto Capitanio Milan, Italy More articles by this author , Rayan MatloobRayan Matloob Milan, Italy More articles by this author , Fabio CastiglioneFabio Castiglione Milan, Italy More articles by this author , Paolo CapogrossoPaolo Capogrosso Milan, Italy More articles by this author , Andrea RussoAndrea Russo Milan, Italy More articles by this author , Cristina CarenziCristina Carenzi Milan, Italy More articles by this author , La Croce GiovanniLa Croce Giovanni Milan, Italy More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio Milan, Italy More articles by this author , Andrea GallinaAndrea Gallina Milan, Italy More articles by this author , Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , and Roberto BertiniRoberto Bertini Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.306AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In renal cell carcinoma (RCC) setting, lymph node status at preoperative imaging is affected by a non-negligible false-positive rate. To date, no study has systematically assessed the stage-specific prevalence and the potential predictor of lymph node invasion (LNI) among clinically positive node RCC patient (cN1). METHODS Between 1987 and 2012, 1983 RCC patients underwent either partial or radical nephrectomy at a single tertiary care institution. For the aim of the study, only clinically positive lymph node cases were included (cN1). Descriptive, univariable and multivariable analyses assessed the concordance between preoperative and pathological nodal status. Moreover, clinical predictors of LNI were identified. RESULTS Preoperative axial CT scan revealed 256 (12.9%) patients showing at least one enlarged lymph nodes suspected for lymph node invasion (cN1). Of those, LNI (pN1) was pathologically confirmed in 89 patients (34.8%). The prevalence of pathologically confirmed LNI was 75.4 vs. 24.4%, 64.7 vs. 35.3%, 55.8 vs. 44.2% and 50.0 vs. 50.0% in clinically T1, T2, T3 and T4 cases, respectively (p<0.001). Moreover, 45.7 vs. 27.2% of patients with or without metastases at diagnosis, respectively, showed LNI at final pathology (p=0.001). Finally, mean tumor size was statistically significantly higher (10.0 vs. 8.1 cm, p<0.001) in patients with or without pathologically confirmed LNI. At univariable and multivariable logistic regression analyses, only continuously coded clinical tumor size resulted an independent predictor of LNI among patients with suspected lymphadenectomy at imaging (OR 1.14; p=0.001). CONCLUSIONS Renal cell carcinoma nodal staging imaging is affected by high rate of false-positive rate. Up to 60% of patients showing preoperatively a suspected lymph node does not show LNI at final pathological report. Among patients with clinically positive nodes, clinical tumor size represents the most informative and independent predictor of confirmed LNI at final pathology. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e306 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Umberto Capitanio Milan, Italy More articles by this author Rayan Matloob Milan, Italy More articles by this author Fabio Castiglione Milan, Italy More articles by this author Paolo Capogrosso Milan, Italy More articles by this author Andrea Russo Milan, Italy More articles by this author Cristina Carenzi Milan, Italy More articles by this author La Croce Giovanni Milan, Italy More articles by this author Paolo Dell'Oglio Milan, Italy More articles by this author Andrea Gallina Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Roberto Bertini Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...