The association between renal tumour scoring system components and complications of partial nephrectomy

Abstract

Introduction: We evaluate the associations between 3 renal tumour scoring systems and their components with perioperative complications of partial nephrectomy. Methods: A consecutive cohort of partial nephrectomy patients was analyzed. Patient characteristics were abstracted from medical records. PADUA scores (preoperative aspects and dimensions used for anatomic classification), RENAL (radius exophyic/endophytic nearness anterior/posterior location scoring) nephrometry scores, and Centrality index (C-index) were determined from preoperative axial images by 2 independent reviewers. Cases were evaluated for postoperative complications up to 30 days after surgery. Pre-specified complication definitions were used for 33 potential medical and surgical complications. Unadjusted and adjusted associations between overall scores, individual components, and complications were determined using log binomial regression. Results: In total, 118 patients were included in the study. Of these, 36 (30.5%) surgical complications occurred in 27 (22.9%) patients. Fourteen (11.9%) were Clavien grade ≥3. Overall PADUA score was significantly associated with surgical and overall complications after adjusting for potential confounders. Among all components of the 3 scoring systems, only tumour diameter and exophytic/ endophytic nature of the tumour were significantly associated with complications after adjusting for the other components of the respective scoring system (p < 0.05). Conclusions: Renal tumour scoring systems may help predict the risk of complications after partial nephrectomy. Further refinement of current systems is required. A first step would be to include only components that are significantly associated with complications.

Predictive factors of overall and major postoperative complications after partial nephrectomy: Results from a multicenter prospective study (The RECORd 1 project)

“…7,4,21 However, Desantis et al suggested that some clinical tumor features included in the nephrometry scores, such as clinical diameter and endophytic growth pattern, seem more predictive of complications than others do. 22 In the present study, nephrometry scores were not reported as they had been introduced in literature after the generation of this prospective database (2008). Nevertheless, all nephrometry tumor features, such as clinical diameter, growth pattern, polar site, localization including hilar location and side, were descripted and none of these significantly predicts surgical complications.…”

PADUA and R.E.N.A.L. nephrometry scores correlate with perioperative outcomes of robot‐assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI‐RUS) database

“…Notably, the total PADUA score performed slightly better than the other systems for WIT and, unsurprisingly, correlated with the absolute change of eGFR after surgery. Desantis et al recently reported data of 118 patients diagnosed with clinically localised renal tumours in a single Canadian Institution. After adjusting for age and medical comorbidities, only the PADUA score was found to be significantly correlated with surgical (OR 1.31, P = 0.02) and overall (OR 1.12, P = 0.04) complications at ≤30 days of surgery.…”

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

“…Desantis et al . [ 25 ] reported PADUA score having significant correlation with surgical (OR 1.31, P = 0.02) and overall (OR 1.12, P = 0.04) complications at ≤30 days of surgery. This retrospective study included a cohort of 118 patients with clinically localized renal tumors and who underwent PN in a single institution.…”