The Performance of a Modified RENAL Nephrometry Score in Predicting Renal Mass Radiofrequency Ablation Success

Gahan, Jeffrey; Richter, Michael; Seideman, Casey A.; Trimmer, Clayton; Chan, Danny Tat Ming; Weaver, M. Lance; Olweny, Ephrem O.; Cadeddu, Jeffrey A.

doi:10.1016/j.urology.2014.08.026

Cited by 43 publications

(24 citation statements)

References 11 publications

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“…The results of our analyses suggest that these scoring systems are significantly but only modestly associated with local tumor recurrence. When modified tumor size scoring criteria were used as previously described by Gahan et al (19), the predictive strength of the RENAL score increased only slightly.…”

Section: Ablative Therapiesmentioning

confidence: 98%

“…However, although higher mean PADUA and RENAL scores have been associated with increased rates of local recurrence in prior studies (16)(17)(18), the magnitude of these associations has not been elucidated fully. Moreover, the relative contribution of each individual scoring system variable (eg, tumor location) to the prediction of clinical outcomes after renal mass ablation previously has been the subject of only limited evaluation (19). Finally, whether the prediction of local recurrence can be improved…”

Section: Patientsmentioning

confidence: 99%

“…A modified RENAL score also was calculated, which included the aforementioned RENAL scoring components, with the size variable reapportioned (3 cm, .3 but ,4 cm, or 4 cm). This score has been previously described (19). Two combination scores also were calculated: a novel modified PADUA score composed of only the variables radius, polarity, sinus relationship, and collecting system relationship and the combination of radius and sinus relationship.…”

Section: Use Of the Scoring Systemsmentioning

confidence: 99%

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Renal Cell Carcinoma: Comparison of RENAL Nephrometry and PADUA Scores with Maximum Tumor Diameter for Prediction of Local Recurrence after Thermal Ablation

et al. 2017

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Purpose To evaluate the performance of the radius, exophytic or endophytic, nearness to collecting system or sinus, anterior or posterior, and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomic classification (PADUA) scoring systems and other tumor biometrics for prediction of local tumor recurrence in patients with renal cell carcinoma after thermal ablation. Materials and Methods This HIPAA-compliant study was performed with a waiver of informed consent after institutional review board approval was obtained. A retrospective evaluation of 207 consecutive patients (131 men, 76 women; mean age, 71.9 years ± 10.9) with 217 biopsy-proven renal cell carcinoma tumors treated with thermal ablation was conducted. Serial postablation computed tomography (CT) or magnetic resonance (MR) imaging was used to evaluate for local tumor recurrence. For each tumor, RENAL nephrometry and PADUA scores were calculated by using imaging-derived tumor morphologic data. Several additional tumor biometrics and combinations thereof were also measured, including maximum tumor diameter. The Harrell C index and hazard regression techniques were used to quantify associations with local tumor recurrence. Results The RENAL (hazard ratio, 1.43; P = .003) and PADUA (hazard ratio, 1.80; P< .0001) scores were found to be significantly associated with recurrence when regression techniques were used but demonstrated only poor to fair discrimination according to Harrell C index results (C, 0.68 and 0.75, respectively). Maximum tumor diameter showed the highest discriminatory strength of any individual variable evaluated (C, 0.81) and was also significantly predictive when regression techniques were used (hazard ratio, 2.98; P < .0001). For every 1-cm increase in diameter, the estimated rate of recurrence risk increased by 198%. Conclusion Maximum tumor diameter demonstrates superior performance relative to existing tumor scoring systems and other evaluated biometrics for prediction of local tumor recurrence after renal cell carcinoma ablation. RSNA, 2016.

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Section: Ablative Therapiesmentioning

confidence: 98%

Section: Patientsmentioning

confidence: 99%

Section: Use Of the Scoring Systemsmentioning

confidence: 99%

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Renal Cell Carcinoma: Comparison of RENAL Nephrometry and PADUA Scores with Maximum Tumor Diameter for Prediction of Local Recurrence after Thermal Ablation

et al. 2017

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“…Ji et al further found improved GFR for laparoscopic CA compared to partial nephrectomy with 5-year follow-up [44]. Similar studies suggest that thermal ablation preserves renal function in patients with pre-existing chronic kidney disease (CKD) and complex tumors [32]. Wehrenberg-Klee et al evaluated 48 patients with a mean GFR of 39.8 mL/min and found no significant change in renal function 1 year after renal mass ablation [45].…”

Section: Renal Function Outcomesmentioning

confidence: 93%

“…nephrometry score, where the R variable was modified to stratify tumors less than 4 cm. They found significant differences in ablation success and recurrence-free survival between low, medium, and high complexity tumors [32,33]. Similarly, Best et al demonstrated 5-year overall disease free survival of 95 % in tumors <3.0 cm compared to 79 % in tumors larger than 3.0 cm [34].…”

Section: Oncologic Outcomes Of Ca and Rfamentioning

confidence: 94%

Ablative Therapies for the Treatment of Small Renal Masses: a Review of Different Modalities and Outcomes

2016

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The widespread utilization of abdominal imaging has led to an increase in incidentally detected small renal masses. Although partial nephrectomy is still considered the gold standard treatment for these masses, there are risks associated with surgical excision, potentially limiting treatment for older patients with multiple comorbidities. A variety of ablative techniques have developed over the past several decades, altering the management of small renal masses. It is likely that improvements in technology will only broaden the applications of ablative therapy. This article provides an update on the various ablative techniques and outcomes.

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Radiofrequency Ablation of Renal Tumors

Steinberg

Tracy

2018

Smith's Textbook of Endourology

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The Performance of a Modified RENAL Nephrometry Score in Predicting Renal Mass Radiofrequency Ablation Success

Cited by 43 publications

References 11 publications

Renal Cell Carcinoma: Comparison of RENAL Nephrometry and PADUA Scores with Maximum Tumor Diameter for Prediction of Local Recurrence after Thermal Ablation

Renal Cell Carcinoma: Comparison of RENAL Nephrometry and PADUA Scores with Maximum Tumor Diameter for Prediction of Local Recurrence after Thermal Ablation

Ablative Therapies for the Treatment of Small Renal Masses: a Review of Different Modalities and Outcomes

Radiofrequency Ablation of Renal Tumors

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