How is kidney cancer staging diagnosed?

The natural history of kidney cancer provides us with a basis for evaluating patients and staging. When evaluating a patient with hematuria, back pain, or a mass in the waist or abdomen, we should ask whether there are systemic symptoms such as weight loss, fever, and discomfort. Macroscopic hematuria with streaky blood clots indicates that bleeding occurs in the upper urinary tract. So how is kidney cancer staged? Let's find out.

During the physical examination, attention should be paid to the presence of hypertension and supraclavicular lymphadenopathy. Lumbar or abdominal masses may be accompanied by bruits. The right varicocele that does not disappear when lying flat suggests the possibility of vena cava tumor thrombosis. Standard laboratory tests should include complete blood cell count, coagulation function test and serum biochemistry test. Bone scan should be performed when serum alkaline phosphatase is elevated or there are symptoms of bone pain.
Preoperative diagnosis of renal cancer depends on the results of imaging examinations, which can provide the most direct diagnostic basis. At the same time, imaging diagnostic technology can also make accurate tumor staging in most cases, which is crucial for the selection of subsequent treatment methods.
Usually, imaging examinations start with B-ultrasound, and the diagnostic value of intravenous pyelography is relatively small. CT scanning is the best way to understand the location, size, range, nature and metastasis of the tumor, so it has become the most reliable tool for diagnosing renal cancer. Smaller tumors generally do not require examinations of the cavities and veins. If the patient has a larger right-sided tumor, caval angiography or MRI examination should be performed. MRI is now more commonly used to understand whether the tumor involves the vena cava and perform differential diagnosis. Cystoscopy should also be considered when there is hematuria. Renal artery angiography has a certain role in the diagnosis of renal cancer, especially selective or superselective renal artery embolization can be performed at the same time, which is conducive to the subsequent surgery. Due to the possibility of needle tract implantation and metastasis, there is controversy over the application value of Tru-cut for puncture biopsy, but the development of fine needle cytology biopsy technology has greatly reduced the possibility of implantation and metastasis.