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Difference between revisions of "Total nephrectomy for tumour grossing"
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Total nephrectomy for tumour grossing (view source)
Revision as of 02:10, 5 January 2015
, 02:10, 5 January 2015→Protocol notes
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===Protocol notes=== | ===Protocol notes=== | ||
*Tumour [[stage]] size cut points: <=4 cm, <=7 cm. | *Tumour [[stage]] size cut points: <=4 cm, <=7 cm. | ||
**The 7th edition of the [[TNM staging system]] divides pT2 into pT2a (>7 cm and <=10 cm) and pT2b (>10 cm); however, evidence does not support this subdivision.<ref name=pmid21030143>{{Cite journal | last1 = Waalkes | first1 = S. | last2 = Becker | first2 = F. | last3 = Schrader | first3 = AJ. | last4 = Janssen | first4 = M. | last5 = Wegener | first5 = G. | last6 = Merseburger | first6 = AS. | last7 = Schrader | first7 = M. | last8 = Hofmann | first8 = R. | last9 = Stöckle | first9 = M. | title = Is there a need to further subclassify pT2 renal cell cancers as implemented by the revised 7th TNM version? | journal = Eur Urol | volume = 59 | issue = 2 | pages = 258-63 | month = Feb | year = 2011 | doi = 10.1016/j.eururo.2010.10.005 | PMID = 21030143 }}</ref> | |||
*‡ It is important to sample the renal vein wall if tumour thrombus projecting out of the renal vein, as a positive margin is called based on microscopic involvement of/adherence to the vein wall.<ref name=pmid24025521>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Grignon | first2 = DJ. | last3 = Bonsib | first3 = SM. | last4 = Amin | first4 = MB. | last5 = Billis | first5 = A. | last6 = Lopez-Beltran | first6 = A. | last7 = Samaratunga | first7 = H. | last8 = Tamboli | first8 = P. | last9 = Delahunt | first9 = B. | title = Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1505-17 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e31829a85d0 | PMID = 24025521 }}</ref> | *‡ It is important to sample the renal vein wall if tumour thrombus projecting out of the renal vein, as a positive margin is called based on microscopic involvement of/adherence to the vein wall.<ref name=pmid24025521>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Grignon | first2 = DJ. | last3 = Bonsib | first3 = SM. | last4 = Amin | first4 = MB. | last5 = Billis | first5 = A. | last6 = Lopez-Beltran | first6 = A. | last7 = Samaratunga | first7 = H. | last8 = Tamboli | first8 = P. | last9 = Delahunt | first9 = B. | title = Handling and staging of renal cell carcinoma: the International Society of Urological Pathology Consensus (ISUP) conference recommendations. | journal = Am J Surg Pathol | volume = 37 | issue = 10 | pages = 1505-17 | month = Oct | year = 2013 | doi = 10.1097/PAS.0b013e31829a85d0 | PMID = 24025521 }}</ref> | ||
**Tumour projecting out of the vein (i.e. at the surface of specimen), at the time of grossing, is presumed to be due to retraction of the vein after it is cut. | **Tumour projecting out of the vein (i.e. at the surface of specimen), at the time of grossing, is presumed to be due to retraction of the vein after it is cut. | ||