[Preoperative staging of renal cell carcinoma. Comparison with operative or pathologic finding]

Fifty-two cases of renal cell carcinoma (cases with metastatic episode during follow-up period excluded) operated on and whose pathohistological staging had been established at our department clinic during a period of 11 years from January 1973 to December 1983 were studied. Renal arteriography i.e., selective renal arteriography, aortography, was performed on 49 cases, and CT scan and ultrasonic examination were performed on 19 and 15 cases, respectively for analytical comparison of the preoperative staging with the postoperative staging as based on the operative or pathological findings (Robson et al.). Staging was found correct in 33 of the 49 cases (67.3%) by arteriography and 16 of the 19 cases (84.2%) by CT scan. In the current study, ultrasonic assessment was possible only in those cases of venous infiltrations i.e., tumor embolism affecting the renal vein or the vena cava inferior. Most effective in the cases with extracapsular infiltrations or localized lymph node metastases was the CT scan. Correct diagnosis was also possible in 6 of the 8 cases (75%) with venous infiltrations if the arteriograms had been analysed in detail, and both the CT scan and the ultrasonic examination proved effective in this type of cases as well. These findings may suggest that the CT scan alone is sufficient for making a localized staging.