A novel nephrometry scoring system for predicting peri-operative outcomes of retroperitoneal laparoscopic partial nephrectomy
- Author:
- No author available
- Journal Title:
- Chinese Medical Journal
- Issue:
- 5
- DOI:
- 10.1097/CM9.0000000000000668
- Key Word:
- Laparoscopy;Nephrectomy;RENAL score;Mayo adhesive probability score;Laparoscopy;Nephrectomy;RENAL score;Mayo adhesive probability score
Abstract： Background::Although the impact of tumor complexity on peri-operative outcomes has been well established using several nephrometry scoring systems, the impact of adherent perirenal fat remains poorly defined. This study aimed to develop a novel nephrometry scoring system for predicting the peri-operative outcomes of laparoscopic partial nephrectomy (LPN) by integrating and optimizing the RENAL score (RNS) and Mayo adhesive probability (MAP) score.Methods::We retrospectively evaluated 159 patients treated with retroperitoneal LPN. The patients’ demographic parameters, RNSs, and MAP scores were evaluated as potential predictors of perioperative outcomes, including operation time, estimated blood loss (EBL), and margin, ischemia, and complication (MIC) achievement rate. The independent predictors were used to develop a novel nephrometry scoring system. The predictive value and inter-observer agreement for the novel nephrometry scoring system were evaluated.Results::Tumor radius (R score), nearness to the renal sinus or collecting system (N score), and posterior perinephric fat thickness were independent predictors of peri-operative outcomes and were used to develop the RNP score. The univariate analysis revealed that the RNP score was significantly associated with operation time, EBL, and MIC achievement rate ( P < 0.050). The RNP score was an independent predictor of operation time ( P < 0.001), EBL ( P = 0.018), and MIC achievement rate ( P = 0.023) in the multivariate analysis. The RNP score was not inferior to RNS in the area under the curve for predicting peri-operative outcomes and performed better in inter-observer agreement (76.7% vs. 57.8%) and kappa value (0.804 vs. 0.726). Conclusion::The RNP score, combining the advantages of the RNS and MAP score, demonstrated a good predictive value for the peri-operative outcomes of retroperitoneal LPN and better inter-observer agreement.
- [1]Davidiuk,A.J.,Parker,A.S.,Thomas,C.S.,etc.Mayo adhesive probability score: An accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy[J].2014,66(6).
- [2]Yin Zheng,Patrick Espiritu,Tariq Hakky,etc.Predicting ease of perinephric fat dissection at time of open partial nephrectomy using preoperative fat density characteristics[J].2014,114(6).
- [3]E R, DeLong,D M, DeLong,D L, Clarke-Pearson.Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach.[J].1988,44.
- [4]Giacomo Novara,Silvia Secco,Vincenzo Ficarra.Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) Classification of Renal Tumours in Patients who are Candidates for Nephron-Sparing Surgery[J].2009,56(5).
- [5]Matthew N. Simmons,Amr F. Fergany,Byron H. Lee,etc.Diameter-Axial-Polar Nephrometry: Integration and Optimization of R.E.N.A.L. and Centrality Index Scoring Systems[J].2012,188(2).
- [6]Khene, Zine-Eddine,Bensalah, Karim,Largent, Axel,etc.Role of quantitative computed tomography texture analysis in the prediction of adherent perinephric fat[J].2018,36(10).
- [7]Khene, Zine-Eddine,Peyronnet, Benoit,Kocher, Neil J.,etc.Predicting morbidity after robotic partial nephrectomy: The effect of tumor, environment, and patient-related factors[J].2018,36(7).
- [8]Dariane, Charles,Le Guilchet, Thomas,Hurel, Sophie,etc.Prospective assessment and histological analysis of adherent perinephric fat in partial nephrectomies[J].2017,35(2).
- [9]Conrad M. Tobert,Allen Shoemaker,Richard J. Kahnoski,etc.Critical appraisal of first-generation renal tumor complexity scoring systems: Creation of a second-generation model of tumor complexity[J].2015,33(4).
- [10].The Application of "Renal Pedicle Rotation" Method in Retroperitoneal Laparoscopic Partial Nephrectomy for Renal Ventral Tumors[J].2015,29(9).
- [11]Davidiuk, Andrew J.,Parker, Alexander S.,Thomas, Colleen S.,etc.Prospective Evaluation of the Association of Adherent Perinephric Fat With Perioperative Outcomes of Robotic-assisted Partial Nephrectomy[J].2015,85(4).
- [12]Krane LS,Mufarrij PW,Hemal AK,etc.Does nephrometry scoring of renal tumors predict outcomes in patients selected for robot-assisted partial nephrectomy?[J].2011,25(10).
- [13]Martin, Logan,Rouviere, Olivier,Bezza, Riadh,etc.Mayo Adhesive Probability Score Is an Independent Computed Tomography Scan Predictor of Adherent Perinephric Fat in Open Partial Nephrectomy[J].2017,103.
- [14]Koo,K.C.,Yoo,H.,Shin,T.Y.,etc.External validation of the RENAL nephrometry score nomogram for predicting high-grade renal cell carcinoma in solid, enhancing, and small renal masses[J].2014,32(1).
- [15]Lughezzani,G.,Ficarra,V.,Guazzoni,G.,etc.Margin, ischemia, and complications (MIC) score in partial nephrectomy: A new system for evaluating achievement of optimal outcomes in nephron-sparing surgery[J].2012,62(4).
- [16]Dulabon LM,Kaouk JH,Haber GP,etc.Multi-institutional analysis of robotic partial nephrectomy for hilar versus nonhilar lesions in 446 consecutive cases.[J].2011,59(3).
- [17]Massimiliano Spaliviero,Bing Ying Poon,Omer Aras,etc.Interobserver variability of R.E.N.A.L., PADUA, and centrality index nephrometry score systems[J].2014,33(6).
- [18]Kutikov A,Uzzo RG.The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth.[J].2009,182(3).
- [19]Khene, Zine-Eddine,Peyronnet, Benoit,Mathieu, Romain,etc.Analysis of the impact of adherent perirenal fat on peri-operative outcomes of robotic partial nephrectomy[J].2015,33(11).
- [20]Nie, Sarah,Lehman, Erik,Kunchala, Sudhir,etc.Adherent perinephric fat at minimally invasive partial nephrectomy is associated with adverse peri-operative outcomes and malignant renal histology[J].2016,117(4).
- [21]Mager, Rene,Reiss, Ann-Kathrin,Haferkamp, Axel,etc.RENAL Score Outperforms PADUA Score, C-Index and DAP Score for Outcome Prediction of Nephron Sparing Surgery in a Selected Cohort[J].2016,196(3).
- [22]Wang,L.,Wu,Z.,Ye,H.,etc.Correlations of Tumor Size, RENAL, Centrality Index, Preoperative Aspects and Dimensions Used for Anatomical, and Diameter-axial-polar Scoring with Warm Ischemia Time in a Single Surgeon's Series of Robotic Partial Nephrectomy[J].2014,83(5).