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Objective To compare the clinical efficacy of different margins in nephron-sparing operation for patients with small renal cell carcinoma. Methods From September 2008 to April 2013, a total of 64 patients with local renal cell carcinoma (T1a period) and treated with nephron-sparing operation were selected, and the clinic data were analyzed. According to cutting edge size gotten from the surgery, the patients were divided in to A group (cutting edge 1-5 mm group, 30 cases) and B group (cutting edge 6-10 mm group, 34 cases). The operation condition and recurrence rate and survival rate of two groups were compared. Results The operative time in A group was significantly shorter than that in B group:(130.1 ± 24.0) min vs. (152.3 ± 28.0) min, P0.05). The 3-year recurrence rate and 3-year survival rate in two groups had no significant differences (P>0.05). Conclusions The clinical efficacy of different margins in nephron-sparing operation for small renal cell carcinoma is similar. But 1- 5 mm cutting edge size nephron-sparing operation has less complications, and the recurrence rate and survival rate does not increase. It is worthy of spread .
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Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of small renal cell carcinoma (SRCC) and renal angiomyolipoma (AML) with minimal fat.Methods The images and data of conventional ultrasound (US) and CEUS were retrospectively reviewed in 47 cases of small renal cell carcinoma and 8 cases of AML with minimal fat (d ＜ 30mm),which were confirmed by operation and pathologicall study,including 39 males and 16 females.The mean age of the patients was (54.8 ± 9.8) years old,ranged from 31 to 73 years old.The size,echo,boundary and color flow signals of renal lesions were observed by conventional US.Then the modality and phases of enhancement were observed,including the arrival time,the peak time,the washout time and the appearance of internal structures.Results On contrast-enhanced sonography,fast wash-in and wash-off were observed in most of SRCC,while slow wash-off were observed in most of RAML with minimal fat.The statistically significant differences were found between SRCC and RAML with minimal fat in the values of TFP (time a to peak) and PI (peak-intensity).The occurrence of round pseudo-capsule and contrast-enhancement characteristics in SRCC was far more often than RAML with minimal fat.Conclusions Contrast-enhanced sonography combined with time-intensity analysis provides more useful information for the diagnosis of SRCC and AML with minimal fat.
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Objective To investigate the association of prognosis with clinical features,tumor imaging,and pathological grading and staging in small renal cell carcinoma(SRCC). Methods The clinical data of 76 cases of SRCC (no more than 3 cm in diameter) were analyzed retrospectively.According to the clinical symptoms,they were divided into two groups,symptomatic (hematuria and lumbago) group (n=17,accounting for 22.4%) and asymptomatic group (n=59,77.6%).All the 76 cases underwent CT scan,with the diagnosis rate of 94.7%;69 cases underwent B-ultrasound examination with the diagnosis rate of 84.1%. Results All the 76 cases underwent radical nephrectomy through oblique incision in the lumbus.The excised tumors were pathologically confirmed to be clear cell carcinoma.The patients were followed up for 32 to 87 months(mean,62.7 months).The 1-,3-,and 5-year cancer-free survival rates of the symptomatic and asymptomatic groups were 100% and 53.3%,33.3% and 100%,90.6% and 77.4%,respectively.There were statistically significant differences between the two groups in the 3- and 5-year cancer-free survival rates (P
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Objective To evaluate the value of helical CT scan in the diagnosis of small renal cell carcinoma.Methods The helical CT features of small renal cell carcinoma proved by operation and pathology in 14 cases were studied retrospectively.Results CT showedisodense mass in 7 cases,slightly low density mass in 5 cases,slightly hyperdense mass in 1 case,cystic and solid mass in 1 case,and among them 2 cases showed punctural calcification.The lesions showed marked enhancement in cortical phase in 12 cases,slight to moderateenhancement in 2 cases,in parenchymal phase,the tumor density dropped promptly,and in the pelvic phase the tumor density droppedfurther. Conclusion Small renal cell carcinoma is of certain characteristic on multi-phasic spiral CT contrast-enhanced scan,it is a very valuable method in diangosis of small renal cell carcinoma.