Workup/Staging Flashcards

1
Q

How is RCC diagnosed?

A

RCC requires a tissue Dx. Often, nephrectomy is both diagnostic and therapeutic. Percutaneous Bx can also be employed for surgically unfit pts, those considering active surveillance, or at the time of ablative therapy.

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2
Q

What % of biopsied pts have benign Dz?

A

∼33% of small renal masses may be characterized as benign according to the specimen obtained. The risk of benign pathology is inversely proportional to the size of the renal mass.

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3
Q

What imaging is important in the initial workup of RCC?

A

Imaging workup typically includes contrast-enhanced CT or MRI scan of the abdomen and chest imaging. Consider bone scan and MRI brain if clinically indicated.

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4
Q

Summarize the AJCC 8th edition (2017) T staging for RCC.

A

TX: primary tumor cannot be assessed

T0: no evidence of primary tumor

T1: limited to kidney and ≤7 cm

T1a: ≤4 cm

T1b: >4 and ≤7 cm

T2: limited to kidney and >7 cm

T2a: >7 cm but ≤10 cm

T2b: >10 cm

T3: invades into major veins or perinephric tissues but not into ipsi adrenal gland and not beyond Gerota fascia

T3a: extends into renal vein or its segmental branches, or invades the pelvicalyceal system, or invades perirenal and/or renal sinus fat but not beyond Gerota fascia

T3b: extends into vena cava below diaphragm

T3c: extends into vena cava above diaphragm or invades wall of vena cava

T4: invades beyond Gerota fascia, including contiguous extension into ipsi adrenal gland

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5
Q

Summarize the AJCC 8th edition (2017) stage grouping for RCC.

A

Stage I: T1N0M0

Stage II: T2N0M0

Stage III: T1–2N1M0 or T3N0–1M0

Stage IV: T4 or M1

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6
Q

What other staging systems are widely used for RCC?

A

The Flocks and Kadesky system (with or without Robson modification) and Jewett–Strong classification system have been used to stage RCC.

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7
Q

Name 3 prognostic factors for RCC.

A

Prognostic factors for RCC:

  1. TNM stage
  2. PS
  3. Fuhrman grade
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