External Validation of a Nomogram Using RENAL Nephrometry Score to Predict High Grade Renal Cell Carcinoma

Wang, Hong Kai; Zhu, Yao; Yao, Xu; Zhang, Shi Lin; Dai, Bo; Zhang, Hai Liang; Shen, Yi; Wang, Chao‐Fu; Ye, Ding Wei

doi:10.1016/j.juro.2011.12.099

Cited by 57 publications

(33 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The area under the curve for these two models was 0.76 and 0.73 respectively, 28 with the latter being validated externally by another group. 29 Even though we found no correlation in our study between Fuhrman grade and RNS, with further development and external validation, there may be a role for RENAL nephrometry in the decision making process when allocating patients to active surveillance or used alongside percutaneous biopsies for histological diagnosis. There are further potential roles for the RNS in renal oncological surgery.…”

contrasting

confidence: 66%

Prediction of complications after partial nephrectomy by RENAL nephrometry score

Reddy

Pillai

Parker

et al. 2014

annals

View full text Add to dashboard Cite

INTRODUCTION Discussing and planning the appropriate management for suspicious renal masses can be challenging. With the development of nephrometry scoring methods, we aimed to evaluate the ability of the RENAL nephrometry score to predict both the incidence of postoperative complications and the change in renal function after a partial nephrectomy. METHODS This was a retrospective study including 128 consecutive patients who underwent a partial nephrectomy (open and laparoscopic) for renal lesions in a tertiary UK referral centre. Univariate and multivariate ordinal regression models were used to identify associations between Clavien-Dindo classification and explanatory variables. The Kendall rank correlation coefficient was used to examine an association between RENAL nephrometry score and a drop in estimated glomerular filtration rate (eGFR) following surgery. RESULTS An increase in the RENAL nephrometry score of one point resulted in greater odds of being in a higher Clavien-Dindo classification after controlling for RENAL suffix and type of surgical procedure (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.04-1.64, p=0.043). Furthermore, a patient with the RENAL suffix 'p' (ie posterior location of tumour) had increased odds of developing more serious complications (OR: 2.60, 95% CI: 1.07-6.30, p=0.042). A correlation was shown between RENAL nephrometry score and postoperative drop in eGFR (Kendall's tau coefficient -0.24, p=0.004). CONCLUSIONS To our knowledge, this is the first study that has shown the predictive ability of the RENAL nephrometry scoring system in a UK cohort both in terms of postoperative complications and change in renal function.

show abstract

contrasting

confidence: 66%

Prediction of complications after partial nephrectomy by RENAL nephrometry score

Reddy

Pillai

Parker

et al. 2014

annals

View full text Add to dashboard Cite

show abstract

“…The area under the curve was 73% and 76% for malignancy and high grade, respectively. External validation revealed an area under the curve of 73% for prediction of high-grade disease [40]. Likewise, recent studies showed that higher tumor complexity according to the RENAL score is associated with high-grade disease and clear-cell subtype [41,42].…”

Section: Evidence Synthesismentioning

confidence: 99%

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

et al. 2015

View full text Add to dashboard Cite

Context A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. Objective To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). Evidence acquisition A literature review was conducted. Evidence synthesis Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. Conclusions Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. Patient summary In this report we review renal surgical anatomy. Renal mass imaging allows detailed delineation of the anatomy and vasculature and permits nephrometry scoring, and thus precise, patient-specific surgical planning. Novel off-clamp techniques have been developed that may lead to improved outcomes.

show abstract

“…This nomogram has been externally validated. 12 The Kutikov nomogram has a predictive capability of malignant potential and tumor grade (high or low) similar to core renal mass biopsy.…”

Section: Nomograms and Risk Assessment Toolsmentioning

confidence: 99%

Management of Small Renal Masses in the Older Adult

Mirza

2015

Clinics in Geriatric Medicine

View full text Add to dashboard Cite

External Validation of a Nomogram Using RENAL Nephrometry Score to Predict High Grade Renal Cell Carcinoma

Abstract: We confirm the predictive value of the nomogram using the RENAL nephrometry score to identify high grade renal cell carcinoma in an independent cohort. Further research is required to evaluate its performance using a head-to-head comparison with renal biopsy results.

Cited by 57 publications

References 28 publications

Prediction of complications after partial nephrectomy by RENAL nephrometry score

Prediction of complications after partial nephrectomy by RENAL nephrometry score

A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy

Management of Small Renal Masses in the Older Adult

Contact Info

Product

Resources

About