Archive | 2019
Comparison of Three-dimensional Calculated Tumor Size, Radiologic Tumor Size, and Pathologic Tumor Size in Renal Cell Carcinoma
Abstract
ABS TRACT Objective: The aim of the study was to investigate the correlation between tumor sizes of surgical specimens and tumor sizes obtained preoperatively by radiology and three-dimensional (3D) segmentation in our series. Material and Methods: All patients underwent an intravenous contrast-enhanced abdominal computed tomography (CT) within 4 weeks before surgery. The size of the tumor on CT was measured in coronal, sagittal and transverse axes. The radiologic tumor size (RTS) was defined as the largest of these three measurements. Tomography data were uploaded to 3D segmentation software (Dornheim Segmenter?). The largest diameter of the tumor was measured and defined as 3D-calculated tumor size (3DTS).The largest diameter of the tumor in the pathologic specimen was defined as the pathologic tumor size (PTS). Afterward, the mean measurements of RTS, PTS, and 3DTS were calculated and compared. Results: A total of 113 patients were included in the study. Mean age was 64.2±13.1 years. There were 61 (54%) men and 52 (46%) women. While 65 (57.5%) patients underwent radical nephrectomy (RN), 48 (42.5%) underwent partial nephrectomy (PN). The most common histology was clear cell 93 (82.3%) while the most common pathologic stage was T2a 40 (35.4%). The mean 3DTS was 7.5±3.2, the mean RTS was 7.1±3.1 cm and the mean PTS was 6.8±2.8 (p <0.001). Comparison of 3 DTS, PTS, and PTS according to the grade revealed that high-grade tumors seem to be larger than low-grade tumors with all of 3 measurement methods. Conclusion: Our study found that RTS was overestimated compared to PTS. Similarly, 3DTS of a tumor was overestimated compared to PTS. Additionally, we found that high-grade tumors were larger than low-grade tumors. Three-dimensional measurement of tumor size could be utilized preoperatively for assessment of tumor. However, it should be kept in mind that three-dimensional imaging modalities could overestimate the tumor size compared to pathologic specimens.