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Published on: April 12, 2017
The shrinkage effect of formalin on renal cell carcinoma: Does it change the stages
Murat Akgul1, Aysegul Isal Arslan2, Cenk Yazici3
1Department of Urology, Tekirdag Namik Kemal University School of Medicine, Turkey.
Objective:
To determine the shrinkage effect of formalin on renal cell carcinoma.
Methods:
The retrospective study was conducted from October to November 2020 at Tekirdağ Namık Kemal University, Turkey, and comprised all radical and partial nephrectomy cases performed by a single surgeon in a single clinic between January 2014 and August 2020. Pre-operative images and post-operative pathology were reviewed by the same clinician. Pre-operative longest tumour diameter of radiological images and pathological specimens measured after formalin fixation shrinkage were compared, and the effect of the difference between the two measurements on the circumference of the tumour was examined. The formalin-related shrinkage rates of renal tumours according to the tumour size and the tumour types were also analysed. Data was analysed using SPSS 20.
Results:
Of the 101 cases, 58(57.4%) were of radical and 43(42.6%) of partial nephrectomy. Also, there were 77(76.2%) renal cell carcinoma cases, 22(21.8%) benign renal tumours and 2(1.9%) had other malignant tumours. There were 59(58.4%) males and 42(41.6%) females with an overall mean age of 58.1±12,2 years (range: 30-82 years). The mean radiological size of the renal tumours was 55.3±30.4 mm and it was 52.9±31.6 mm at pathological examination (p>0.05).
Conclusion:
Formalin fixation of tissues post-surgery caused a difference between the radiological and pathological dimensions. Though the difference was no significant, under-staging due to the shrinkage post-surgery should be considered.
Insights
Formalin fixation causes shrinkage in renal tumors, affecting post-surgery measurements. While not statistically significant in this study, this formalin effect on renal cell carcinoma dimensions warrants consideration for accurate staging.
Area of Science:
- Urology
- Pathology
- Oncology
Background:
- Accurate tumor measurement is crucial for staging and treatment planning in renal cell carcinoma.
- Formalin fixation is a standard procedure for preserving tissue specimens for pathological examination.
- Potential dimensional changes due to formalin fixation can impact the accuracy of post-operative pathological assessments.
Purpose of the Study:
- To evaluate the shrinkage effect of formalin fixation on renal tumors.
- To compare pre-operative radiological tumor diameter with post-operative pathological measurements.
- To analyze the impact of formalin-induced shrinkage on tumor dimensions and staging.
Main Methods:
- Retrospective analysis of 101 radical and partial nephrectomy cases (January 2014 - August 2020).
- Comparison of pre-operative longest tumor diameter from radiological images with post-operative pathological specimen measurements after formalin fixation.
- Analysis of formalin-related shrinkage rates based on tumor size and type.
Main Results:
- The mean radiological tumor size was 55.3±30.4 mm, compared to 52.9±31.6 mm post-pathological examination.
- No statistically significant difference (p>0.05) was observed between radiological and pathological tumor dimensions.
- Renal cell carcinoma constituted 76.2% of the cases studied.
Conclusions:
- Formalin fixation leads to dimensional differences between pre-operative radiological and post-operative pathological tumor measurements.
- Although not statistically significant in this cohort, potential under-staging due to formalin shrinkage should be considered in clinical practice.
- Further research may be needed to quantify the precise impact of formalin fixation on various renal tumor subtypes.
