Chest X-Rays May Miss Pulmonary Metastases in T1a RCC Patients
Findings in patients treated for T1a renal cell carcinoma followed with X-ray surveillance.
(HealthDay News) -- For patients treated for T1a renal cell carcinoma, chest X-rays have low diagnostic yield for detecting pulmonary metastases, according to a study published in the August issue of The Journal of Urology.
Noah E. Canvasser, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues examined the usefulness of chest X-rays for T1a renal cell carcinoma surveillance. A total of 258 patients with T1a renal cell carcinoma were treated with partial nephrectomy, radical nephrectomy, or radio frequency ablation, with surveillance follow-up. Demographics, pathological findings, and surveillance records were identified during retrospective chart review. The incidence of asymptomatic pulmonary recurrences diagnosed by chest X-ray was the primary outcome.
The researchers found that 3 patients developed pulmonary metastases, but standard chest X-ray surveillance diagnosed only 1 case. Each patient completed a mean of 3.3 surveillance chest X-rays during a median follow-up of 36 months. There was no significant difference in the recurrence rate for partial nephrectomy, radical nephrectomy, or radio frequency ablation (0, 0, and 1 cases, respectively; P =0.09).
"Chest X-rays are a low yield diagnostic tool for detecting pulmonary metastasis in patients treated for T1a renal cell carcinoma," the authors write. "Treatment mode does not appear to influence the need for chest X-ray surveillance."
1. Canvasser NE, Stouder K, Lay AH, et al. The Usefulness of Chest X-Rays for T1a Renal Cell Carcinoma Surveillance. J Urol. 2016 Aug. 196v2;321–326. doi: 10.1016/j.juro.2016.02.068. [Epub ahead of print]