Is there a need for pelvic CT scan in cases of renal cell carcinoma?
OBJECTIVE
To determine the necessity of pelvic computed tomography (CT) in patients of renal cell carcinoma (RCC).


METHODS
We reviewed the records of 400 patients of RCC, who underwent treatment at our institution between January 1988 and February 2001. These patients were evaluated pre-operatively with ultrasonograms (USG) and contrast enhanced CT scan of the abdomen and pelvis. USG or CT scans of these cases were reviewed for presence of pathology in the pelvis, which were classified into 3 categories viz; benign and likely to be insignificant, benign and likely to be significant; and malignant.


RESULTS
Of the 400 cases, 114 were stage I, 68 were stage II, 99 were stage III and 119 were stage IV. In all patients, tumour was identified in the kidney on preoperative CT scan. Fourteen patients (3.5%) had an abnormality on pelvic CT. Five (1.25%) had category 1, three (0.75%) had category 2 and six (1.5%) had category 3 abnormality on pelvic CT. However, all these abnormalities in pelvis were detected prior to CT by other investigations (USG or plain x-ray). Of the six cases with malignant findings, two had superficial bladder cancer, one had RCC in a pelvic kidney and three had bone metastases in the pelvis.


CONCLUSIONS
Pelvic CT does not offer additional information in the vast majority of cases with RCC and should be performed selectively. Thus the cost of diagnostic imaging in RCC can be reduced.
Khaitan
Anurag
A
Department of Urology, All India Institute of Medical Sciences, New Delhi.
Gupta
Narmada P
NP
Hemal
Ashok K
AK
Dogra
P N
PN
Seth
Amlesh
A
Aron
Monish
M
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009367:Neoplasm Staging; D009392:Nephrectomy; D010388:Pelvis / Q000000981:diagnostic imaging; D011300:Preoperative Care / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures