The Usefulness of Chest X-Rays for T1a Renal Cell Carcinoma Surveillance

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose The overall incidence of pulmonary metastasis of T1 renal cell carcinoma is low. We evaluated the usefulness of chest x-rays based on the current AUA (American Urological Association) guidelines and NCCN Guidelines® for T1a renal cell carcinoma surveillance. Materials and Methods Between 2006 and 2012, 258 patients with T1a renal cell carcinoma were treated with partial nephrectomy, radical nephrectomy or radio frequency ablation with surveillance followup at our institution. A retrospective chart review was performed to identify demographics, pathological findings and surveillance records. The primary outcome was the incidence of asymptomatic pulmonary recurrences diagnosed by chest x-ray in cases of T1a disease. Our secondary outcome was a comparison of diagnoses by treatment modality (partial nephrectomy, radical nephrectomy or radio frequency ablation). Results Pulmonary metastases developed in 3 of 258 patients (1.2%) but only 1 (0.4%) was diagnosed by standard chest x-ray surveillance. Median followup in the entire cohort was 36 months (range 6 to 152) and 193 of 258 patients (75%) had greater than 24 months of followup. A mean of 3.3 surveillance chest x-rays were completed per patient. When assessed by treatment type, there was no significant difference in the recurrence rate for partial nephrectomy (0 of 191 cases), radical nephrectomy (0 of 22) or radio frequency ablation (1 of 45 or 2.2%) (p = 0.09). Conclusions Chest x-rays are a low yield diagnostic tool for detecting pulmonary metastasis in patients treated for T1a renal cel carcinoma. Treatment mode does not appear to influence the need for chest x-ray surveillance.

Original languageEnglish (US)
Pages (from-to)321-326
Number of pages6
JournalJournal of Urology
Volume196
Issue number2
DOIs
StatePublished - Aug 1 2016

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Nephrectomy
Renal Cell Carcinoma
Thorax
X-Rays
Radio
Lung
Neoplasm Metastasis
Guidelines
Recurrence
Incidence
Therapeutics
Demography
Carcinoma
Kidney

Keywords

  • carcinoma, renal cell
  • kidney neoplasms
  • lung neoplasms
  • mass chest x-ray
  • neoplasm metastasis

ASJC Scopus subject areas

  • Urology

Cite this

The Usefulness of Chest X-Rays for T1a Renal Cell Carcinoma Surveillance. / Canvasser, Noah E.; Stouder, Kylee; Lay, Aaron H.; Gahan, Jeffrey C.; Lotan, Yair; Margulis, Vitaly; Raj, Ganesh V.; Sagalowsky, Arthur I.; Cadeddu, Jeffrey A.

In: Journal of Urology, Vol. 196, No. 2, 01.08.2016, p. 321-326.

Research output: Contribution to journalArticle

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abstract = "Purpose The overall incidence of pulmonary metastasis of T1 renal cell carcinoma is low. We evaluated the usefulness of chest x-rays based on the current AUA (American Urological Association) guidelines and NCCN Guidelines{\circledR} for T1a renal cell carcinoma surveillance. Materials and Methods Between 2006 and 2012, 258 patients with T1a renal cell carcinoma were treated with partial nephrectomy, radical nephrectomy or radio frequency ablation with surveillance followup at our institution. A retrospective chart review was performed to identify demographics, pathological findings and surveillance records. The primary outcome was the incidence of asymptomatic pulmonary recurrences diagnosed by chest x-ray in cases of T1a disease. Our secondary outcome was a comparison of diagnoses by treatment modality (partial nephrectomy, radical nephrectomy or radio frequency ablation). Results Pulmonary metastases developed in 3 of 258 patients (1.2{\%}) but only 1 (0.4{\%}) was diagnosed by standard chest x-ray surveillance. Median followup in the entire cohort was 36 months (range 6 to 152) and 193 of 258 patients (75{\%}) had greater than 24 months of followup. A mean of 3.3 surveillance chest x-rays were completed per patient. When assessed by treatment type, there was no significant difference in the recurrence rate for partial nephrectomy (0 of 191 cases), radical nephrectomy (0 of 22) or radio frequency ablation (1 of 45 or 2.2{\%}) (p = 0.09). Conclusions Chest x-rays are a low yield diagnostic tool for detecting pulmonary metastasis in patients treated for T1a renal cel carcinoma. Treatment mode does not appear to influence the need for chest x-ray surveillance.",
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author = "Canvasser, {Noah E.} and Kylee Stouder and Lay, {Aaron H.} and Gahan, {Jeffrey C.} and Yair Lotan and Vitaly Margulis and Raj, {Ganesh V.} and Sagalowsky, {Arthur I.} and Cadeddu, {Jeffrey A.}",
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AU - Canvasser, Noah E.

AU - Stouder, Kylee

AU - Lay, Aaron H.

AU - Gahan, Jeffrey C.

AU - Lotan, Yair

AU - Margulis, Vitaly

AU - Raj, Ganesh V.

AU - Sagalowsky, Arthur I.

AU - Cadeddu, Jeffrey A.

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N2 - Purpose The overall incidence of pulmonary metastasis of T1 renal cell carcinoma is low. We evaluated the usefulness of chest x-rays based on the current AUA (American Urological Association) guidelines and NCCN Guidelines® for T1a renal cell carcinoma surveillance. Materials and Methods Between 2006 and 2012, 258 patients with T1a renal cell carcinoma were treated with partial nephrectomy, radical nephrectomy or radio frequency ablation with surveillance followup at our institution. A retrospective chart review was performed to identify demographics, pathological findings and surveillance records. The primary outcome was the incidence of asymptomatic pulmonary recurrences diagnosed by chest x-ray in cases of T1a disease. Our secondary outcome was a comparison of diagnoses by treatment modality (partial nephrectomy, radical nephrectomy or radio frequency ablation). Results Pulmonary metastases developed in 3 of 258 patients (1.2%) but only 1 (0.4%) was diagnosed by standard chest x-ray surveillance. Median followup in the entire cohort was 36 months (range 6 to 152) and 193 of 258 patients (75%) had greater than 24 months of followup. A mean of 3.3 surveillance chest x-rays were completed per patient. When assessed by treatment type, there was no significant difference in the recurrence rate for partial nephrectomy (0 of 191 cases), radical nephrectomy (0 of 22) or radio frequency ablation (1 of 45 or 2.2%) (p = 0.09). Conclusions Chest x-rays are a low yield diagnostic tool for detecting pulmonary metastasis in patients treated for T1a renal cel carcinoma. Treatment mode does not appear to influence the need for chest x-ray surveillance.

AB - Purpose The overall incidence of pulmonary metastasis of T1 renal cell carcinoma is low. We evaluated the usefulness of chest x-rays based on the current AUA (American Urological Association) guidelines and NCCN Guidelines® for T1a renal cell carcinoma surveillance. Materials and Methods Between 2006 and 2012, 258 patients with T1a renal cell carcinoma were treated with partial nephrectomy, radical nephrectomy or radio frequency ablation with surveillance followup at our institution. A retrospective chart review was performed to identify demographics, pathological findings and surveillance records. The primary outcome was the incidence of asymptomatic pulmonary recurrences diagnosed by chest x-ray in cases of T1a disease. Our secondary outcome was a comparison of diagnoses by treatment modality (partial nephrectomy, radical nephrectomy or radio frequency ablation). Results Pulmonary metastases developed in 3 of 258 patients (1.2%) but only 1 (0.4%) was diagnosed by standard chest x-ray surveillance. Median followup in the entire cohort was 36 months (range 6 to 152) and 193 of 258 patients (75%) had greater than 24 months of followup. A mean of 3.3 surveillance chest x-rays were completed per patient. When assessed by treatment type, there was no significant difference in the recurrence rate for partial nephrectomy (0 of 191 cases), radical nephrectomy (0 of 22) or radio frequency ablation (1 of 45 or 2.2%) (p = 0.09). Conclusions Chest x-rays are a low yield diagnostic tool for detecting pulmonary metastasis in patients treated for T1a renal cel carcinoma. Treatment mode does not appear to influence the need for chest x-ray surveillance.

KW - carcinoma, renal cell

KW - kidney neoplasms

KW - lung neoplasms

KW - mass chest x-ray

KW - neoplasm metastasis

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