The following is a summary of “CT features based preoperative predictors of aggressive pathology for clinical T1 solid renal cell carcinoma and the development of nomogram model,” published in the January 2024 issue of Oncology by Wang et al.

In this retrospective study involving 776 patients with cT1 solid renal cell carcinoma (RCC) treated with partial nephrectomy (PN) or radical nephrectomy (RN) from 2018 to 2022, the study group aimed to identify robust preoperative predictors of aggressive pathology by integrating clinical features with qualitative and quantitative computed tomography (CT) parameters. Aggressive pathology was defined as nuclear grade III-IV, upstaging to pT3a, or specific subtypes of RCC associated with aggressive features. 

Four-phase contrast-enhanced CT scans were analyzed by experienced radiologists to extract relevant parameters. Logistic regression analyses identified neutrophil-to-lymphocyte ratio (NLR), distance to the collecting system, CT necrosis, tumor margin irregularity, peritumoral neovascularity, and RER-NP as independent predictors of aggressive pathology. A nomogram model incorporating these variables demonstrated strong predictive accuracy (area under the curve = 0.854). 

The study underscores the crucial role of preoperative CT in predicting aggressive pathology in cT1 solid RCC, providing a valuable nomogram to guide treatment decisions and postoperative management. The findings emphasize the significance of integrating clinical and imaging data for improved risk stratification in patients with early-stage renal cell carcinoma.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11870-1