R.E.N.A.L. Score Outperforms PADUA Score, C-Index and DAP Score for Outcome Prediction of Nephron Sparing Surgery in a Selected Cohort

No AccessJournal of UrologyAdult Urology1 Sep 2016R.E.N.A.L. Score Outperforms PADUA Score, C-Index and DAP Score for Outcome Prediction of Nephron Sparing Surgery in a Selected Cohort Hendrik Borgmann, Ann-Kathrin Reiss, Martin Kurosch, Natalie Filmann, Sebastian Frees, Rene Mager, Igor Tsaur, and Axel Haferkamp Hendrik BorgmannHendrik Borgmann Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author , Ann-Kathrin ReissAnn-Kathrin Reiss Department of Urology, University Hospital Frankfurt, Frankfurt, Germany More articles by this author , Martin KuroschMartin Kurosch Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author , Natalie FilmannNatalie Filmann Institute of Biostatistics and Mathematical Modeling, University Hospital Frankfurt, Frankfurt, Germany More articles by this author , Sebastian FreesSebastian Frees Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author , Rene MagerRene Mager Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author , Igor TsaurIgor Tsaur Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author , and Axel HaferkampAxel Haferkamp Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.03.176AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Several nephrometry scores have been proposed to predict perioperative outcomes in renal surgery. We evaluated which nephrometry score correlates best with the MIC (margin, ischemia and complications) score and quantitative perioperative outcomes in nephron sparing surgery. Materials and Methods: Data on 188 patients undergoing nephron sparing surgery were retrospectively investigated for patient, operative and tumor characteristics. Nephrometry scores, including R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, hilar tumor touching the main renal artery or vein and location relative to polar lines), PADUA (preoperative aspects and dimensions used for an anatomical), C-index (concordance index) and DAP (diameter-axial-polar), were measured on preoperative computerized tomography or magnetic resonance imaging and coded continuously and categorically. Parameters pertaining to tumor margin, ischemia and complications were recorded as binary scores and classified as MIC achievement. Operative time, estimated blood loss, warm ischemia time and hospital stay were recorded as quantitative perioperative outcomes. Results: The R.E.N.A.L. score correlated best with MIC and quantitative perioperative outcomes. The continuously coded R.E.N.A.L. score was predictive of MIC on univariate analysis (OR 0.75, 95% CI 0.58–0.97, p = 0.03) and it had the best predictive value on multivariate logistic regression analysis (OR 0.31, 95% CI 0.18–0.82, p = 0.03). The C-index but not the PADUA or the DAP score was predictive of MIC on univariate and multivariate logistic regression analysis. MIC achievement rates were significantly higher for low than for high complexity tumors as assessed by categorically coded R.E.N.A.L. score, C-index and DAP scores. Continuously coded R.E.N.A.L. and PADUA scores positively correlated with operative time, warm ischemia time and hospital stay. The C-index and the DAP score correlated with warm ischemia time. 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Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLaguna M (2019) Re: Comparison of RENAL, PADUA, CSA, and PAVP Nephrometry Scores in Predicting Functional Outcomes after Partial NephrectomyJournal of Urology, VOL. 202, NO. 4, (657-658), Online publication date: 1-Oct-2019. Volume 196Issue 3September 2016Page: 664-671Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsdecision support techniqueskidney neoplasmscomplicationsischemiaprognosisMetricsAuthor Information Hendrik Borgmann Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Ann-Kathrin Reiss Department of Urology, University Hospital Frankfurt, Frankfurt, Germany More articles by this author Martin Kurosch Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Natalie Filmann Institute of Biostatistics and Mathematical Modeling, University Hospital Frankfurt, Frankfurt, Germany More articles by this author Sebastian Frees Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Rene Mager Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Igor Tsaur Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Axel Haferkamp Department of Urology, University Hospital Mainz, Mainz, Germany More articles by this author Expand All Advertisement PDF downloadLoading ...