Tumor size and invasiveness matters for partial nephrectomy: External validation and modification of the arterial based complexity score

Kriegmair, Maximilian C.; Hetjens, Svetlana; Mandel, Philipp; Wadle, Jula; Budjan, Johannes; Michel, Maurice Stephan; Pfalzgraf, Daniel; Wagener, Nina

doi:10.1002/jso.24565

Cited by 8 publications

(15 citation statements)

References 22 publications

(54 reference statements)

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“…Except for one prospective randomized trial [71], all the studies were retrospective. All the studies were found to be of intermediate quality, except for one of high quality [59] ( Table 1). The majority of the studies assessed the predictive role of the RENAL and PADUA scores, mostly regarding complications after NSS ( Supplementary Fig.…”

Section: 2mentioning

confidence: 99%

“…A cumulative analysis of three available studies [59,71,72] showed RENAL as an independent predictor of on-clamp resection (OR: 1.55; 95% CI: 1.23, 1.95; p < 0.001). Each of the PADUA, ABC [59], and MAP [72] scores was assessed in only one study and associated with on-clamp technique (all p < 0.001; Table 2 and the Supplementary material).…”

Section: The Supplementary Material)mentioning

confidence: 99%

“…A pooled analysis of five studies demonstrated that the RENAL score as continuous (OR: 1.53; 95% CI: 1.13, 2.06; p = 0.006) [35][36][37][38]59] or categorical (high complexity; OR: 9.29; 95% CI: 5.37, 16.06; p < 0.001) [35,53] is an [11,30,33,54,55]. Only one study was reported as continuous on DAP [49] and ABC [59] and as categorical on CSA [11], with DAP and CSA found to be independent predictors of WIT (p < 0.01; Table 2 and the Supplementary material). [49], Zhongshan score [15], ZII [17], and SPARE [20], which was shown to be related to overall complications.…”

Section: Warm Ischemia Timementioning

confidence: 99%

Section: Pelvicalyceal System Entry/repairmentioning

confidence: 99%

“…Only two studies per nephrometry score were available regarding this outcome [30,35,54,59]. RENAL as a continuous variable was directly related to pelvicalyceal system entry/repair (OR: 1.53; 95% CI: 1.15, 2.04; p = 0.003) [35,59]. This was not the case for high-complexity RENAL score, whereas high-complexity PADUA score was shown to be an independent predictor of pelvicalyceal effraction (OR: 3.27; 95% CI: 1.96, 5.46; p < 0.001) [30,54].…”

Section: Pelvicalyceal System Entry/repairmentioning

confidence: 99%

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Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis

Veccia

Antonelli

Uzzo

et al. 2020

European Urology Focus

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Context: Over the last decade, several nephrometry scores (NSs) have been introduced with the aim of facilitating preoperative decision making, planning, and counseling in the field of nephron-sparing surgery. However, their predictive role remains controversial. Objective: To describe currently available nephrometry scores and to determine their predictive role for different outcomes by performing a systematic review and metaanalysis of the literature. Evidence acquisition: PubMed, Embase1, and Web of Science were screened to identify eligible studies. Identification and selection of the reports were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A pooled analysis of NS predictive role of intraoperative, postoperative, oncological, and functional outcomes was performed. Odds ratio was considered the effect size. All the analyses were performed using Stata 15.0, and statistical significance was set at p 0.05. Evidence synthesis: Overall, 51 studies meeting our inclusion criteria were identified and considered for the analysis. Except for one prospective randomized trial, all the studies were retrospective. All the studies were found to be of intermediate quality, except for one of high quality. Most studies assessed the predictive role of the Radius-Exophytic/Endophytic-Nearness-Anterior/Posterior-Location (RENAL) and Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) scores, mostly regarding complications after nephron-sparing surgery. RENAL was an independent predictor of an on-clamp procedure (p < 0.001). Mayo Adhesive Probability score was related to adhesive perinephric fat (p = 0.005). Continuous and high-complexity RENAL scores were predictors of warm ischemia time (WIT; p = 0.006 and p < 0.001, respectively). Continuous (p < 0.001) and high-complexity (p < 0.001) PADUA scores were related to WIT. Continuous and high-complexity RENAL scores were predictors of overall complications (p = 0.002 and p < 0.001, respectively). PADUA score was related to complications both as continuous (p < 0.001) and as a categorical value (p < 0.002). The RENAL scores R = 3 (p = 0.008), E = 2 (p = 0.039), and hilar location (p = 0.006) were predictors of histological malignancy. Continuous and categorical RENAL scores were independent

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Section: 2mentioning

confidence: 99%