Friday, August 1, 2008

Advances in diagnosis and follow-up in kidney cancer

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Advances in diagnosis and follow-up in kidney cancer.

Kidney cancer

Current Opinion in Urology. 18(5):447-454, September 2008.
Rioja, Jorge; de la Rosette, Jean JMCH; Wijkstra, Hessel; Laguna, M Pilar

Purpose of review: To review the most recent data on preoperative diagnostic methods in kidney cancer and in follow-up and monitoring after ablation therapy.

Recent findings: Although the role of the percutaneous biopsy in the diagnostics of renal masses has been limited, new data suggest a high accuracy of the percutaneous core biopsy in the diagnostics of malignancy and a fair to perfect interobserver and intraobserver variability. Accuracy in determining the subtype is also high but lower for Fuhrman grade determination. Data on fine needle aspiration remain controversial. Refinements in cross-sectional imaging might have a value in differentiation of low-fat content angiomyolipoma from renal cell carcinoma.

Contrast cross-sectional imaging remains the reference standard in the assessment of ablation results. Contrast-enhanced ultrasound shows promising results in this field but further confirmation is needed.

Summary: Although few changes are evident in the diagnostic imaging of kidney tumors, percutaneous core biopsy has gained attention and in the light of the current results might play an extended role in the preoperative workup of renal masses. New techniques should be investigated for monitoring after ablation therapies in order to reduce toxicity and costs.

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