Objective: To evaluate the accuracy of radiological staging, especially renal venous and perirenal fat invasion, in renal cell carcinoma (RCC). Material & Methods: Data of 4823 renal tumor patients from Renal Tumor Database of Association of Uro-oncology in Turkey were evaluated. Of 4823 patients, 3309 RCC patients had complete radiological and histopathological data were included to this study. The Pearson Chi-squared test (χ2) was used to compare radiological and histopathological stages. Results: The mean (SD) age of 3309 patients was 58 (12.3). Preoperative radiological imaging was performed using computed tomography (CT) (n=2510, 75.8%) or magnetic resonance imaging (MRI) (n=799, 24.2%). There was a substantial concordance between radiological and pathological staging (к=0.52, p<0.001). Sensitivities of radiological staging in stage I, II, III and IV were 90.7%, 67.3%, 27.7% and 64.2%, respectively. The sensitivity in stage III was lower than the other stages. Sub-analysis of stage IIIa cases revealed that, for perirenal fat invasion and renal vein invasion, sensitivity values were 15.4% and 11.3%, respectively. Conclusions: There was a substantial concordance between radiological (CT and/or MRI) and pathological T staging in RCC. However, this is not true for T3 cases. Sensitivity of preoperative radiological imaging in patients with pT3a tumors is insufficient and lower than the other stages. Consequently, preoperative imaging in patients with T3 RCC has to be improved, in order to better inform the patients regarding prognosis of their disease.

Abstract Purpose: To compare the functional outcomes of patients who underwent partial (PN) or radical nephrectomy (RN) for clinical T1 (cT1) renal tumors using the Kidney Cancer Database of the Urooncology Association, Turkey. Methods: We retrospectively reviewed 1004 patients who underwent PN and RN for cT1 renal tumors at multiple academic tertiary centers between 2000 and 2018. Patients with preoperative end-stage chronic kidney disease and/or metastatic disease were excluded. Results: There were 452 patients in the PN group and 552 patients in the RN group. The eGFR was significantly reduced in both groups on postoperative day one (PN=13.7 vs. RN=19.1 ml/min/1.73 m2: p<0.001). In the PN group, eGFR showed a tendency to recover according to a quadratic pattern and reached preoperative levels in the first and third years (95.6±28.8 ml/min/1.73 m2 and 96.9±28.9 ml/min/1.73 m2, respectively), with no significant difference between the eGFRs in the 1st and 3rd years (p=0.710). To define groups at risk, different cut-off values for the GFR were considered. Among patients with a baseline GFR<90, the RN cohort had significantly lower eGFRs in the first and third years than the PN cohort (p=0.02). Logistic regression showed that comorbidities, coronary artery disease, diabetes and hypertension had no adverse impacts on the changes in the eGFR (p=0.60, p=0.13, and p=0.13, respectively). Conclusion: For the treatment of stage T1 kidney tumors, the first choice should be open or laparoscopic partial nephrectomy due to the superior long-term preservation of renal function and overall survival, regardless of age and comorbidities.