Postoperative Outcome of Cystic Renal Cell Carcinoma Defined on Preoperative Imaging: A Retrospective Study

No AccessJournal of UrologyAdult Urology1 Apr 2017Postoperative Outcome of Cystic Renal Cell Carcinoma Defined on Preoperative Imaging: A Retrospective Study Jung Jae Park, Byong Chang Jeong, Chan Kyo Kim, Seong Il Seo, Keumhee C. Carriere, Minji Kim, Byung Kwan Park, Seong Soo Jeon, Hyun Moo Lee, and Han Yong Choi Jung Jae ParkJung Jae Park Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea School of Medicine, Kangwon National University, Chuncheon, Republic of Korea Equal study contribution. More articles by this author , Byong Chang JeongByong Chang Jeong Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Equal study contribution. More articles by this author , Chan Kyo KimChan Kyo Kim Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Medical Device Management and Research, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea More articles by this author , Seong Il SeoSeong Il Seo Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author , Keumhee C. CarriereKeumhee C. Carriere Department of Biostatistics and Clinical Epidemiology Center, Samsung Hospital, Seoul, Republic of Korea Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada More articles by this author , Minji KimMinji Kim Department of Biostatistics and Clinical Epidemiology Center, Samsung Hospital, Seoul, Republic of Korea More articles by this author , Byung Kwan ParkByung Kwan Park Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author , Seong Soo JeonSeong Soo Jeon Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author , Hyun Moo LeeHyun Moo Lee Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author , and Han Yong ChoiHan Yong Choi Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.10.055AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the postoperative outcome of cystic renal cell carcinoma defined on preoperative computerized tomography. We also sought to find the optimal cutoff of the cystic proportion in association with patient prognosis. Material and Methods: In this institutional review board approved study with waiver of informed consent, 1,315 patients were enrolled who underwent surgery for a single renal cell carcinoma with preoperative computerized tomography. The cystic proportion of renal cell carcinoma was determined on computerized tomography. The optimal cutoff of the cystic proportion was explored regarding cancer specific survival. Renal cell carcinomas were categorized as cystic or noncystic renal cell carcinoma according to a conventional cutoff (ie cystic proportion 75% or greater) and an optimal cutoff. Postoperative outcomes were then compared between the 2 groups. Multivariate Cox regression analysis was performed to determine the independent predictor of cancer specific survival. Results: Of the 1,315 lesions 107 (8.1%) were identified as cystic renal cell carcinoma according to a conventional cutoff. The postoperative outcome of cystic renal cell carcinoma was significantly better than that of noncystic renal cell carcinoma (p <0.001). Neither metastasis nor recurrence developed after surgery in patients with cystic renal cell carcinoma. In association with the cancer specific survival rate, the optimal cutoff of the cystic proportion was 45% and 197 cases (15.0%) were accordingly defined as cystic renal cell carcinoma. On Cox regression analysis, a cystic proportion of 45% or greater of the renal cell carcinoma was an independent predictor of a favorable outcome regarding cancer specific survival (HR 0.34, p = 0.03). Conclusions: Cystic renal cell carcinoma defined on preoperative computerized tomography is associated with low metastatic potential and favorable outcomes after surgery. 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Volume 197Issue 4April 2017Page: 991-997 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsx-ray computedrenal cellmortalitylocalcystsneoplasm metastasistomographycarcinomaMetricsAuthor Information Jung Jae Park Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea School of Medicine, Kangwon National University, Chuncheon, Republic of Korea Equal study contribution. More articles by this author Byong Chang Jeong Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Equal study contribution. More articles by this author Chan Kyo Kim Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Medical Device Management and Research, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea More articles by this author Seong Il Seo Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author Keumhee C. Carriere Department of Biostatistics and Clinical Epidemiology Center, Samsung Hospital, Seoul, Republic of Korea Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, Alberta, Canada More articles by this author Minji Kim Department of Biostatistics and Clinical Epidemiology Center, Samsung Hospital, Seoul, Republic of Korea More articles by this author Byung Kwan Park Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author Seong Soo Jeon Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author Hyun Moo Lee Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author Han Yong Choi Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea More articles by this author Expand All Advertisement PDF downloadLoading ...