Preoperative staging of renal cell carcinoma using triphasic helical computed tomography

ObjectiveTo determine if staging of renal cell carcinoma (RCC) can be predicted from preoperative triphasic helical computed tomography (CT) findings.Patients and methodsWe reviewed the triphasic helical CT scans of 48 consecutive patients with pathologic diagnosis RCCs. All tumors were staged according to the 2002 version of TNM staging system. The preoperative radiologic staging was compared with postoperative pathologic staging. Agreement between the two staging systems was determined using the kappa test.ResultsComparison between triphasic helical CT staging and pathologic staging showed harmony in all lesions in stage T1a, and T1b. Triphasic helical CT over diagnosed two cases of stage T1b regarded as stage T3a while agreement was noted in all cases of stage T2. Harmony was noted between triphasic helical CT and pathologic staging in two lesions stage T3a, four lesions in stage T3b, and two lesions stage T4. The agreement between triphasic helical CT and pathologic T stages was perfect (K = 0.941). Forty-two cases were staged N0, one case was N1, and five cases were staged N2 by triphasic CT. Three cases were over staged, and six cases were under staged while, 39 were correctly N staged. The agreement between triphasic helical CT and pathologic N staging was poor (K = 0.33).ConclusionThe agreement between the preoperative triphasic helical CT staging and postoperative pathologic T staging is perfect, while agreement in N stages is poor. So T staging of RCC can be predicted from triphasic helical CT findings while N staging cannot be predicted preoperatively.