|
|
|
| Synchronous lymph node metastasis can help to discriminate sarcomatoid renal cell carcinoma and
clear cell renal cell carcinoma |
| SHU Jun1, TANG Yong-qiang1, MENG Xiao-li2, ZHANG Wei-qi1, YANG Ru-wu2, XU Wan-ni1, ZHANG Jin-song1 |
| 1. Xijing Hospital, Air Force Medical University, Xi’an 710032, China;
2. Department of Radiology, Xi’an XD Group Hospital, Xi’an 710077, China |
|
|
|
|
Abstract Objective: To investigate and compare the synchronous metastasis distribution of sarcomatoid renal cell carcinoma(SRCC) and clear cell renal cell carcinoma(CCRCC), so as to contribute to their differential diagnosis. Methods: Synchronous metastasis means metastasis at the time of diagnosis. A retrospective analysis of the medical records and imaging data of 45 SRCC and 143 CCRCC which diameter larger than 6 cm, all the cases had their preoperative abdominal enhancement CT, analysis their synchronous metastasis distribution by χ2 or Fisher’s exact test. Results: There were 16 SRCC and 10 CCRCC had synchronous metastasis(16/45 vs 10/143), 11 SRCC and 1 CCRCC had synchronous lymph node metastasis(11/45 vs 1/143), 6 SRCC and 6 CCRCC had synchronous lung metastasis(6/45 vs 6/143), 6 SRCC and 1 CCRCC had multiple synchronous metastasis(5/45 vs 1/143), and the differences were statistically significant(P=0.000, 0.000, 0.039, 0.003). However, only synchronous lymph node metastasis remained statistically significant(P=0.030) by Logistic regression. Conclusion: Synchronous lymph node metastasis can help to discriminate SRCC and CCRCC, as this feature is more common in SRCC.
|
|
Received: 02 April 2018
|
|
|
|
|
|
| [1]焦亮，王涌泉. 肾肉瘤样癌研究进展[J]. 临床与病理杂志，2016，36（4）：486-491.
[2]Shuch B, Said J, La Rochelle JC, et al. Cytoreductive nephrectomy for kidney cancer with sarcomatoid histology——is up-front resection indicated and, if not, is it avoidable[J]. J Urol, 2009, 182(5): 2164-2171.
[3]Shuch B, Bratslavsky G, Linehan WM, et al. Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies[J]. Oncologist, 2012, 17(1): 46-54.
[4]Motzer RJ, Jonasch E, Agarwal N, et al. Kidney cancer, Version 2. 2017, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2017, 15(6): 804-834.
[5]Cangiano T, Liao J, Naitoh J, et al. Sarcomatoid renal cell carcinoma biologic behavior, prognosis, and response to combined surgical resection and immunotherapy[J]. J Clin Oncol, 1999, 17(2): 523-528.
[6]Schieda N, Thornhill RE, Al-Subhi M, et al. Diagnosis of sarcomatoid renal cell carcinoma with CT: evaluation by qualitative imaging features and texture analysis[J]. AJR, 2015, 204(5): 1013-1023.
[7]Young JR, Young JA, Margolis DJA, et al. Sarcomatoid renal cell carcinoma and collecting duct carcinoma discrimination from common renal cell carcinoma subtypes and benign RCC mimics on multiphasic MDCT[J]. Acad Radiol, 2017, 24(10): 1226-1232.
[8]Takeuchi M, Kawai T, Suzuki T, et al. MRI for differentiation of renal cell carcinoma with sarcomatoid component from other renal tumor types[J]. Abdom Imaging, 2015, 40(1): 112-119.
[9]Takeuchi M, Urano M, Hara M, et al. Characteristic MRI findings of sarcomatoid renal cell carcinoma dedifferentiated from clear cell renal carcinoma: radiological-pathological correlation[J]. Clin Imaging, 2013, 37(5): 908-912.
[10]Tilki D, Hu B, Nguyen HG, et al. Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy[J]. J Urol, 2015, 193(2): 436-442.
[11]Tirumani SH, Souza D, Krajewski KM, et al. Impact of histologic subtype and sarcomatoid transformation on metastasis in renal cell carcinoma: a single institute experience in 149 patients[J]. Abdom Radiol, 2016, 41(2): 295-302.
[12]Cheville JC, Lohse CM, Zincke H, et al. Sarcomatoid renal cell carcinoma: an examination of underlying histologic subtype and an analysis of associations with patient outcome[J]. Am J Surg Pathol, 2004, 28(4): 435-441.
[13]Blute ML, Leibovich BC, Cheville JC, et al. A protocol for performing extended lymph node dissection using primary tumor pathological features for patients treated with radical nephrectomy for clear cell renal cell carcinoma[J]. J Urol, 2004, 172(2): 465-469.
|
|
|
|
