Fuhrman Grade is Associated with Radiological Features in Patients with Renal Cell Carcinoma Open Access

Abstract

Background
Tumor grade is an important determinant of RCC prognosis that can influence treatment decisions; it is typically measured using the Fuhrman grading scale, originally introduced in 1982. Identifying factors that could be used to predict Fuhrman Grade (FG) without biopsy prior to surgery would be valuable and would avoid the challenges involved with renal mass biopsies.

Objective
We aim to use these data to evaluate the association between radiological feature scores and FG, while considering other clinical variables.

Methods
The present study is based on 171 renal masses from 171 patients at Emory University between 2006 and 2010. Fuhrman grade was dichotomized into a two-tiered grading system, low (FG I and II) versus high (FG III and IV) since adjacent tumor grades share similar prognosis. Radiological features for each patient were evaluated as score sums calculated by adding up the scores given by four readers. The range across the scores for each kidney mass was also calculated as a measure of agreement or disagreement among the readers.

Results
In unadjusted analyses, Overall Aggressiveness Rating (OAR) (p<0.0001), Contour (p<0.0001), Venous Invasion (p=0.0076), Regional Lymph Node Involvement (p<0.0001), Tumor Necrosis (p=0.0004), Tumor Consistency (p=0.0031), Hilar Status (p=0.0022), and Collateral Vascularity (p<0.0001) were all significantly associated with high tumor grade. OAR score sum was significantly associated with high FG (p=0.0029) while controlling for age, sex, tumor size, and disagreement (OAR score range).

Conclusions
This study confirmed the association between FG and radiological features such as OAR, indicating that there may be predictive value in radiological features.

Table of Contents

Table of Contents

Background...Page 1
Methods...Page 4
Results...Page 10
Discussion...Page 14
References...Page 17
Tables...Page 21
Figures...Page 30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Fuhrman grade renal cell carcinoma radiology
Committee Chair / Thesis Advisor	Goodman, Michael, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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