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Is Chest Computed Tomography Always Necessary Following Nephrectomy for Renal Cell Carcinoma? A Pilot Study in Single Tertiary Institution

Authors
 Hong Seon Lee  ;  Won Jun Kang  ;  Nam Hoon Cho  ;  Sung Yoon Park 
Citation
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, Vol.43(2) : 333-337, 2019 
Journal Title
 JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 
ISSN
 0363-8715 
Issue Date
2019
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/surgery* ; Female ; Humans ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery* ; Male ; Middle Aged ; Neoplasms, Second Primary/diagnostic imaging* ; Nephrectomy* ; Pilot Projects ; Postoperative Care/methods* ; Radiography, Thoracic/methods ; Retrospective Studies ; Thoracic Neoplasms/diagnostic imaging*
Abstract
PURPOSE: We evaluated patterns of thoracic recurrence from renal cell carcinoma (RCC) following nephrectomy as a pilot study. METHODS: Data of consecutive 39 patients who had recurrent RCC in the abdomen or thorax following curative nephrectomy were evaluated. Recurrence sites were analyzed with abdomen and chest computed tomography (CT), or positron emission tomography/CT. All patients had no metastasis before initial nephrectomy. Recurrence was classified into 3 types according to the site of initially detected recurrence: (a) abdomen-only type, (b) abdomen and thorax type, and (c) thorax-only type. Vertebral level of recurrence site in the thorax-only level was investigated. University of California Los Angeles-Integrated Staging System was utilized for risk stratification (eg, low, intermediate, and high-risk). RESULTS: Rate of intermediate or high risk was 89.7% (37/39). Rate of thoracic recurrence, regardless of concurrent abdominal recurrence, was 71.8% (28/39). Rate of thorax-only type was 53.8% (21/39). In thorax-only type, median vertebral level of recurrence site was T10 (range, T3-T12), and no patient with low risk had metastasis above the T10 level alone. In intermediate or high risk, 89.2% (33/37) had at least a recurrent lesion at the level of T7 or lower. CONCLUSIONS: In low-risk patients, upper thoracic recurrence alone may be very rare after curative surgery. In majority of intermediate- or high-risk patients, initial recurrence may occur in the abdomen or lower thorax, which indicates abdomen CT covering T7 level may be an effective tool for postoperative follow-up in RCC.
Full Text
https://insights.ovid.com/crossref?an=00004728-201903000-00027
DOI
10.1097/RCT.0000000000000841
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
Park, Sung Yoon(박성윤)
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175190
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