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Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging.

Publication ,  Journal Article
Elkassem, AA; Allen, BC; Sharbidre, KG; Rais-Bahrami, S; Smith, AD
Published in: AJR Am J Roentgenol
September 2021

This article reviews the essential role of imaging in clinical staging and restaging of renal cell carcinoma (RCC). To completely characterize and stage an indeterminate renal mass, renal CT or MRI without and with IV contrast administration is recommended. The critical items for initial clinical staging of an indeterminate renal mass or of a known RCC according to the TNM staging system are tumor size, renal sinus fat invasion, urinary collecting system invasion, perinephric fat invasion, venous invasion, adrenal gland invasion, invasion of the perirenal (Gerota) fascia, invasion into other adjacent organs, the presence of enlarged or pathologic regional (retroperitoneal) lymph nodes, and the presence of distant metastatic disease. Larger tumor size is associated with higher stage disease and invasiveness, lymph node spread, and distant metastatic disease. Imaging practice guidelines for clinical staging of RCC, as well as the role of renal mass biopsy, are highlighted. Specific findings associated with response of advanced cancer to antiangiogenic therapy and immunotherapy are discussed, as well as limitations of changes in tumor size after targeted therapy. The accurate clinical staging and restaging of RCC using renal CT or MRI provides important prognostic information and helps guide the optimal management of patients with RCC.

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Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

September 2021

Volume

217

Issue

3

Start / End Page

541 / 555

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Magnetic Resonance Imaging
  • Kidney Neoplasms
  • Kidney
  • Humans
  • Carcinoma, Renal Cell
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Elkassem, A. A., Allen, B. C., Sharbidre, K. G., Rais-Bahrami, S., & Smith, A. D. (2021). Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging. AJR Am J Roentgenol, 217(3), 541–555. https://doi.org/10.2214/AJR.21.25493
Elkassem, Asser Abou, Brian C. Allen, Kedar G. Sharbidre, Soroush Rais-Bahrami, and Andrew D. Smith. “Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging.AJR Am J Roentgenol 217, no. 3 (September 2021): 541–55. https://doi.org/10.2214/AJR.21.25493.
Elkassem AA, Allen BC, Sharbidre KG, Rais-Bahrami S, Smith AD. Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging. AJR Am J Roentgenol. 2021 Sep;217(3):541–55.
Elkassem, Asser Abou, et al. “Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging.AJR Am J Roentgenol, vol. 217, no. 3, Sept. 2021, pp. 541–55. Pubmed, doi:10.2214/AJR.21.25493.
Elkassem AA, Allen BC, Sharbidre KG, Rais-Bahrami S, Smith AD. Update on the Role of Imaging in Clinical Staging and Restaging of Renal Cell Carcinoma Based on the AJCC 8th Edition, From the AJR Special Series on Cancer Staging. AJR Am J Roentgenol. 2021 Sep;217(3):541–555.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

September 2021

Volume

217

Issue

3

Start / End Page

541 / 555

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Staging
  • Magnetic Resonance Imaging
  • Kidney Neoplasms
  • Kidney
  • Humans
  • Carcinoma, Renal Cell
  • 3202 Clinical sciences
  • 1103 Clinical Sciences