Introduction
Renal Cell Carcinoma (RCC) is the most frequent malignant tumor of the kidney in adults and its incidence has been increasing globally (1). Radical or partial nephrectomy is the standard surgical treatment of RCC. Both the surgical procedure and approach are decided according to the stage of cancer and the tumor features such as location, size and centrality. Prognostic factors of RCC are classified into anatomical, histological, clinical, and molecular by European Association of Urology (EAU) Guidelines on RCC. The anatomical prognostic factors consist of the criteria in the TNM classification system (2). Radiological evaluation with computerized tomography (CT) and/or magnetic resonance imaging (MRI) is used to characterize renal mass and its TNM stage. This information is then used for treatment planning and patient counselling.
Multi-phasic contrast-enhanced CT of abdomen and chest is recommended for the diagnosis and staging of RCC by EAU Guidelines on RCC. The Guidelines also recommend MRI because of some advantages such as better evaluation of venous involvement, avoidance of intravenous CT contrast medium and reduction of radiation (2). CT staging for RCC has been variably accurate, and staging inaccuracies, usually under-staging (most common with Stage T3a disease) in previous studies has been reported (3,4). Two large studies reported that patients upstaged from clinical stage T1 to pathologic stage T3a RCC showed shorter survival outcomes than those without upstaging (5,6). Therefore, accuracy of radiological staging is very important for the management of patients with RCC. The aim of the present study is to investigate the accuracy of radiological staging of RCC in every stage and especially in pT3a cases.