Tumor contour irregularity on preoperative imaging: a practical and useful prognostic parameter for papillary renal cell carcinoma.
Eur Radiol
; 31(6): 3745-3753, 2021 Jun.
Article
in En
| MEDLINE
| ID: mdl-33211144
ABSTRACT
OBJECTIVES:
To illustrate tumor contour irregularity on preoperative imaging with a practical method and further determine its value in predicting disease-free survival (DFS) in patients with pRCC (papillary renal cell carcinoma).METHODS:
We performed a retrospective single-institution review of 267 Chinese pRCC patients between March 2009 and May 2019. Contour irregularity on cross-section was classified into smooth but distorted margin, unsmooth and sharply nodular margin, and blurred margin. Then, the ratio of the cross-section numbers of irregularity and the total tumor was defined as the contour irregular degree (CID). Cox regression and Kaplan-Meier analysis were performed to analyze the impact of CID on DFS. Then, the prognostic performance of CID was compared with pRCC risk stratification published by Leibovich et al.RESULTS:
The median follow-up was 45 months (IQR 23-69), in which 27 (10%) patients had metastasis or recurrence. Observed DFS rates were 95%, 90%, and 88% at 1, 3, and 5 years. The CID was an independent prognostic factor of DFS (HR = 1.048, 95% CI = 1.029-1.068, p < 0.001). The Kaplan-Meier plot showed that high-risk patients (CID ≥ 50%) tended to have a significantly shorter DFS (p < 0.001). The CID and Leibovich's pRCC model for DFS prediction had a C-index of 0.934 (95% CI = 0.907-0.961) and 0.833 (95% CI = 0.739-0.927) respectively.CONCLUSIONS:
With our standard and practical method, the CID can be a reliable imaging marker for DFS prediction in patients with pRCC. KEY POINTS ⢠The updated contour irregularity was an independent parameter for predicting disease-free survival in patients with pRCC. ⢠High-risk pRCC patients (contour irregular degree ≥ 50%) tended to have a shorter disease-free survival. ⢠Tumor contour irregularity in pRCC risk stratification outperformed Leibovich's model from our cohort.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
/
Kidney Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Eur Radiol
Journal subject:
RADIOLOGIA
Year:
2021
Document type:
Article
Affiliation country:
China