[The reliability of computed tomography (CT) in the local (T) and lymph node (N) staging of kidney adenocarcinoma].
OBJECTIVE
We investigated the reliability of local (T) and lymph node (N) category staging of renal adenocarcinoma by CT in patients submitted to radical nephrectomy.


METHODS
The study comprised 109 patients with renal adenocarcinoma who had undergone radical nephrectomy from 1986-1994. The preoperative staging was done using dynamic CT. Clinical staging was based on the CT data and pathological staging was determined by the pathological findings. All patients had a transperitoneal radical nephrectomy. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for tumors localized to the kidney, perirenal fat invasion, central venous and lymphatic invasion were analyzed.


RESULTS
The overall sensitivity rate was 67%; the sensitivity and specificity rates were 77% and the PPV and NPV were 89.5% and 67%, respectively, for tumors localized to the kidney. The sensitivity rate was 66%, specificity was 76% and the PPV and NPV were 48.5% and 87.5%, respectively, for those with perirenal fat invasion. Tumors with venous spread showed a sensitivity of 90%, specificity of 92%, PPV 53% and NPV 99%. Concerning lymph node invasion, the sensitivity was 50%, specificity 96%, PPV 50%, NPV 96%.


CONCLUSIONS
CT has a very low sensitivity and specificity in detecting fat invasion, a very high sensitivity and specificity for venous invasion and a low sensitivity, but high specificity in detecting lymphatic spread.
Herranz Amo
F
F
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, España.
Hernández Moreno
L
L
Diez Cordero
J M
JM
Verdú Tartajo
F
F
Rodríguez Fernández
E
E
Lledó García
E
E
González Chamorro
F
F
Bueno Chomon
G
G
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
Fiabilidad de la tomografía computarizada (TC) en el estadiaje local (T) y ganglionar (G) del adenocarcinoma de riñón.