[Transitional cell carcinoma of the upper urinary tract- staging by computed tomography].

PURPOSE: To determine the accuracy of computed tomography (CT) in staging transitional cell carcinoma of the renal pelvis and calyces and to identify whether hydronephrosis proximal to the tumor used as a criterion for minimal invasion may improve the overall accuracy of the method.

MATERIALS AND

METHODS

24 patients with transitional cell carcinoma of the upper urinary tract underwent preoperative CT. In all cases nephroureterectomy was performed and CT and pathologic staging were compared.

RESULTS

Pathologic staging revealed two stage I tumors, eight stage II tumors, five stage III tumors, and 9 stage IV tumors. The initial overall CT staging accuracy was 66.66% (16 of 24 patients). Reevaluation of the CT studies by using proximal hydronephrosis as a criterion for minimal invasion improved the overall CT staging accuracy (83.33%).

CONCLUSIONS

When CT demonstrates direct tumor extension through the pelvic wall, it is a sensitive indicator of high-stage tumor. Hydronephrosis proximal to the tumor may cause overstaging of stage 0-II disease.