Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Renal Cell Carcinoma Intravascular Spread Into Segmental Branches of the Renal Vein: A Single Institution Case Series

Version 1 : Received: 30 December 2020 / Approved: 4 January 2021 / Online: 4 January 2021 (11:31:46 CET)

How to cite: Mastropasqua, M.G.; Mariano, M.; Fusco, F.; Cazzato, G.; Ruggiero, V.; Battaglia, M.; Lucarelli, G.; Ingravallo, G.; Maiorano, E. Renal Cell Carcinoma Intravascular Spread Into Segmental Branches of the Renal Vein: A Single Institution Case Series. Preprints 2021, 2021010019 (doi: 10.20944/preprints202101.0019.v1). Mastropasqua, M.G.; Mariano, M.; Fusco, F.; Cazzato, G.; Ruggiero, V.; Battaglia, M.; Lucarelli, G.; Ingravallo, G.; Maiorano, E. Renal Cell Carcinoma Intravascular Spread Into Segmental Branches of the Renal Vein: A Single Institution Case Series. Preprints 2021, 2021010019 (doi: 10.20944/preprints202101.0019.v1).

Abstract

(1) Background: Overall survival of the patients with renal cell carcinoma (RCC) depends mostly on extra-renal extension, documented by the invasion of the pelvicalyceal system, or the perinephric/renal sinus fat or the renal vein/its segmental intraparenchymal branches. Staging may be challenging because of the high inter-observer variability. We have introduced a more accurate procedure to detect the extra-renal extension and, to possibly evaluate the impact of such more laborious approach, we have compared the RCC pathological staging obtained following both standard and modified procedures; (2) Methods: We selected 54 consecutive cases of RCC diagnosed 18 months before and 54 consecutive cases diagnosed 18 months after the introduction of the new method of sampling. Clinico-pathological characteristics have been statistically analyzed; (3) Results: Most of the features analyzed were non statistically significative, except the extra-renal invasion. More precisely, the occurrence of retrograde venous invasion was higher in the cases grossly approached with the more accurate method; (4) Conclusions: Extra-renal extension to intraparenchymal renal vein branches may be underestimated, leading to an inappropriate under-staging. Using more accurate staging procedures, to disclose the occurrence of intra-renal veins tumoral thrombosis, helps to better define the pathological stage, allowing patients to benefit of better fitting treatments.

Keywords

Renal Cell Carcinoma; Pathological staging; Extrarenal extension; Renal vein invasion

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