Computer tomography-based shape of tumor contour and texture of tumor heterogeneity are independent prognostic indicators for clinical T1b–T2 renal cell carcinoma

Purpose To evaluate association between computer tomography (CT)-based features of renal cell carcinoma (RCC) and survival outcomes. Methods Data of 958 patients with clinical T1b–T2 RCC who underwent partial/radical nephrectomy from June 2003 to March 2022 were retrospectively evaluated. CT images of patients were reviewed by two radiologists for texture analysis of tumor heterogeneity and shape analysis of tumor contour. Patients were divided into three groups according to patterns of CT-based features: (1) favorable feature group ( n = 117); (2) intermediate feature group ( n = 606); and (3) unfavorable feature group ( n = 235). Kaplan–Meier survival analysis and multivariate Cox regression analysis were performed to evaluate overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). Results RCCs with unfavorable CT-based feature showed larger size on CT, higher nuclear grade, higher rate of histologic necrosis, and higher rate of capsular invasion than those in the other two groups (all p