Staging CT chest for cT1a renal masses: Does it change management?
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2025
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| author | Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran |
| author_facet | Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran |
| collection | Wiley Open Access |
| contents | Staging CT chest for cT1a renal masses: Does it change management? Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran BJUI Compass AbstractObjectivesBaseline staging investigations for renal masses invariably include a CT of the chest. However, EAU guidelines have given a weak recommendation that CT chest can be omitted in incidental T1a tumours (≤4 cm) without systemic symptoms, due to the low incidence of pulmonary metastases. This study aimed to assess if a baseline staging CT chest has been clinically useful in a cohort with T1a renal tumours.MethodsConsecutive patients with solid and cystic cT1a renal tumours were prospectively screened for eligibility to the NEST study (ISRCTN 18156881) at a single tertiary referral centre multidisciplinary team meeting (MDT). Four hundred consecutive eligible patients between 28/05/2019 and 13/01/2021 were included in this study. Electronic records were reviewed retrospectively for follow‐up data. Seventeen patients with incomplete follow‐up data were excluded.ResultsOf 383 included patients (63% male, median age 65 years, median tumour diameter 2.4 cm), 264 (69%) had a baseline CT chest as part of their clinical staging investigations. No thoracic renal metastases were diagnosed. Abnormalities were reported in 37/264 cases (14%), including indeterminate lung lesions in 32 patients that were deemed benign on further investigations, three synchronous primary lung tumours, one pre‐existing mesothelioma and one pleural effusion related to known renal failure.ConclusionCT chest is of limited value in clinical staging investigations for cT1a renal tumours and has a negligible impact on subsequent renal tumour management. Rather, it triggered further investigations and follow‐up for 14% of incidentalomas and ultimately detected concurrent incidental primary lung tumours in 1% of patients. 10.1002/bco2.70068 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1002/bco2.70068 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_bco2_70068 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Staging CT chest for cT1a renal masses: Does it change management? Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran BJUI Compass Staging CT chest for cT1a renal masses: Does it change management? Sanjana Ilangovan Hannah Warren Federica Sordelli Thet Paing Oo Pyae Phyo Tun Prasad Patki Faiz Mumtaz Ravi Barod Axel Bex Maxine Tran BJUI Compass AbstractObjectivesBaseline staging investigations for renal masses invariably include a CT of the chest. However, EAU guidelines have given a weak recommendation that CT chest can be omitted in incidental T1a tumours (≤4 cm) without systemic symptoms, due to the low incidence of pulmonary metastases. This study aimed to assess if a baseline staging CT chest has been clinically useful in a cohort with T1a renal tumours.MethodsConsecutive patients with solid and cystic cT1a renal tumours were prospectively screened for eligibility to the NEST study (ISRCTN 18156881) at a single tertiary referral centre multidisciplinary team meeting (MDT). Four hundred consecutive eligible patients between 28/05/2019 and 13/01/2021 were included in this study. Electronic records were reviewed retrospectively for follow‐up data. Seventeen patients with incomplete follow‐up data were excluded.ResultsOf 383 included patients (63% male, median age 65 years, median tumour diameter 2.4 cm), 264 (69%) had a baseline CT chest as part of their clinical staging investigations. No thoracic renal metastases were diagnosed. Abnormalities were reported in 37/264 cases (14%), including indeterminate lung lesions in 32 patients that were deemed benign on further investigations, three synchronous primary lung tumours, one pre‐existing mesothelioma and one pleural effusion related to known renal failure.ConclusionCT chest is of limited value in clinical staging investigations for cT1a renal tumours and has a negligible impact on subsequent renal tumour management. Rather, it triggered further investigations and follow‐up for 14% of incidentalomas and ultimately detected concurrent incidental primary lung tumours in 1% of patients. 10.1002/bco2.70068 http://creativecommons.org/licenses/by/4.0/ |
| title | Staging CT chest for cT1a renal masses: Does it change management? |
| topic | BJUI Compass |
| url | https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.70068 |