Effect of Multidisciplinary Approach in Diagnosis of Renal Sinus Fat Invasion in Renal Cell Cancer

Abstract

Objective: In order to make the most appropriate treatment decision for kidney masses, accurate radiological evaluation is vital. In this study, we aimed to discuss how would be the concordance between a multidisciplinary approach to renal masses and the histopathological outcome. Materials and Methods: Between June 2017 and July 2019, 75 patients who were evaluated for complex renal tumors at the Council of Uroradiology and treated at our clinic were included in the study and their clinical-pathological data were examined. After radiological reporting, all patients were re-evaluated in this council consisting of 4 urologists and 2 radiologists. Results: Forty-three patients underwent partial nephrectomy and 32 patients underwent radical nephrectomy. Malignant histopathology was present in 85.3% of patients. The mass was solid in 35 patients and was of cystic nature in 40 patients. Cystic and solid component assessments were similar in both groups. There was no difference between the two groups in terms of tumor node metastasis staging. Subgroup analysis showed that the correlation between radiological T3 and pathological T3 was not significant in radiology reports. However, this correlation was significant in the council assessment (p<0.001). Conclusion: As a result, the more important factor than the surgical method is which masses will be operated on and which masses will be monitored. Especially in complex patients, it is important to take this decision with a multidisciplinary approach and, if possible, with a team collaboration. Multidisciplinary evaluation has enabled us to achieve better results in determining the T3 stage, which is a factor that can change the surgical method and patient follow-up.