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. 2018 Jul-Sep;10(3):270-279.
doi: 10.4103/UA.UA_11_18.

Validation of radius exophytic/endophytic nearness anterior/posterior location and preoperative aspects and dimensions used for an anatomical nephrometric scores in patients undergoing partial nephrectomy for renal cancer: A single-center experience and literature review

Sachin Yallappa  1   2 , Rizwana Imran  1 , Ishtiakul Rizvi  1 , Omar M Aboumarzouk  2 , Rupesh Bhatt  1 , Prashant Patel  1
Affiliations

Validation of radius exophytic/endophytic nearness anterior/posterior location and preoperative aspects and dimensions used for an anatomical nephrometric scores in patients undergoing partial nephrectomy for renal cancer: A single-center experience and literature review

Sachin Yallappa et al. Urol Ann. 2018 Jul-Sep.

Abstract

Introduction: Nephrometric scores are used to predict perioperative and postoperative complications, with no uniform results in the current literature.

Materials and methods: A retrospective study of 141 patients in a single center who underwent open partial nephrectomy between June 2006 and 2016 for T1a and T1b renal tumor was conducted. Univariate and multivariate analyses were used to evaluate the correlations between preoperative aspects and dimensions used for an anatomical (PADUA) and radius exophytic/endophytic nearness anterior/posterior location (RENAL) scores and their components with pre-, peri-, and post-operative parameters. Linear regression (F-tests) and logical regression models were used to test for significance of the association and predictability of outcomes.

Results: Total RENAL score (P = 0.032), its components R (P = 0.004), E (P = 0.022), L (P = 0.011), and total PADUA score (P = 0.016) were significantly associated with ischemic time. In postoperative complications, the PADUA components: sinus line location (P = 0.008), lateral/medial rim score (P = 0.029), and collecting system score (P = 0.006) showed significance. None of the variables showed correlation with operation time and change in estimated glomerular filtration rate (eGFR). On multivariate analysis, sinus line location and gender (P = 0.012) showed significance in predicting eGFR changes and RENAL score component: A (P = 0.049) was significant in predicting estimated blood loss. Both RENAL and PADUA components were significantly associated with hospital length of stay.

Conclusion: Both RENAL and PADUA scores showed important correlation in predicting outcomes. We further demonstrated the importance of knowing the individual components of the scores, which can independently give outcome predictions. The scoring systems can still be improved and standardized for broad clinical use with larger cohort and multicenter-based studies.

Keywords: Nephrometric scores; partial nephrectomy; preoperative aspects and dimensions used for an anatomical score; radius exophytic/endophytic nearness anterior/posterior location score; renal cancer.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
CONSORT diagram showing the flow of study population through the study
Figure 2
Figure 2
Ischaemic time increased with the total RENAL score. This is more evident with boxplots of ischemic time against the categories of the RENAL score
Figure 3
Figure 3
Ischemic time increased with the total preoperative aspects and dimensions used for an anatomical score; however, this is poorly evident on boxplots of ischemic time against the categories of the preoperative aspects and dimensions used for an anatomical score
See this image and copyright information in PMC

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