Renal cell carcinoma (RCC) is the most common type of kidney cancer worldwide. While radiologists assess enhancement patterns of renal tumors to predict tumor pathology, to our knowledge, no formal scoring system has been created and validated to assess the level of neovascularity in RCC, despite its critical role in cancer metastases.
In this study, we characterized and analyzed the level of angiogenesis in tumor-burdened kidneys and their benign counterparts. We then created and validated a scoring scale for neovascularity that can help predict tumor staging for RCC.
After Institutional Review Board approval, the charts of patients who had undergone surgery for RCC between January 13, 2014 and February 4, 2020 were retrospectively reviewed for inclusion in this study. Inclusion criteria were a diagnosis of RCC, simple/radical nephrectomy, pre-operative contrast enhanced computed tomography (CT) scans, and complete pathology reports. Neovascularity was scored on a scale of 0 to 4 where 0= no neovascularity detected, 1= a single vessel <3 mm wide, 2= a single vessel ≥3 mm wide, 3= multiple vessels <3 mm wide, and 4= multiple vessels ≥3 mm wide.
A total of 227 patients were included in this study. The majority of tumor pathology was clear cell carcinoma, regardless of tumor staging. The average neovascularity score was 1.07 for pT1x tumors, 2.83 for pT2x tumors, and 3.04 for pT3x tumors. There was a significant difference in neovascularity score between pT1x and pT2x tumors (p = 0.0046), pT1x and pT3x tumors (p < 0.0001), and benign kidneys and kidneys with RCC (p = <0.0001).
Our novel vascular scoring system for renal cell carcinoma demonstrates significant correlation with RCC pathological tumor staging. This scoring system may be utilized as part of a comprehensive radiological assessment of renal tumors, potentially improving tumor characterization and clinical decision making.
Journal of endourology. 2022 Nov 11 [Epub ahead of print]
Cameron Fateri, Akhil Peta, Luke Limfueco, Thanh-Lan Bui, Nina Kar, Justin Glavis-Bloom, Bradley Roth, Jaime Landman, Roozbeh Houshyar
University of California Irvine School of Medicine, 12219, Radiology, Orange, California, United States; ., University of California Irvine, 8788, Urology, 333 City Blvd, Suite 2170, Orange, California, United States, 92868; ., University of California Irvine School of Medicine, 12219, Urology, Orange, California, United States; ., University of California Irvine, 8788, Radiological Sciences, Orange, California, United States; ., University of California Irvine School of Medicine, 12219, Urology, Orange, California, United States; ., University of California Irvine School of Medicine, 12219, Radiological Sciences, Orange, California, United States; ., University of California Irvine School of Medicine, 12219, Radiology, Irvine, California, United States; ., University of California Irvine, 8788, Urology, Orange, California, United States; ., University of California Irvine School of Medicine, 12219, Radiology, 101 The City Dr., Orange, California, United States, 92868; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36367194