Quality and Quantity in Kidney Cancer Surgery

• Published in: American journal of clinical pathology 2019-01, Vol.151 (1), p.108-115
• Main Authors: Pruthi, Deepak K, Oomah, Sacha, Lu, Vivian, Ting, Tommy, Knickle, Corey, Liss, Michael A, Gibson, Ian W, Kirkpatrick, Iain D C, McGregor, Thomas B
• Format: Article
• Language: English
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/ajcp/aqy107

Abstract Objectives To model renal function 2 years following radical nephrectomy with quantitative analyses using clinical, histopathologic, and renal composite cortical volumes (CCV). Methods This retrospective study involved an assessment of the nonneoplastic kidney tissue by three blinded nephropathologists using modified Banff 1997 criteria for renal allograft pathology. Volumetric image acquisition was obtained by three independent radiologists using preoperative imaging. A 2-year estimated glomerular filtration (eGFR) calculator was created. Results Among the 126 patients, median age was 60 years; median CCV, 398.1 cm3; preoperative eGFR, 77 mL/min/1.73 m2; and 2-year postoperative eGFR, 54 mL/min/1.73 m2. Of the subjects, 64% had hypertension, 26% diabetes, and 37% were smokers. Increasing age, glomerulopathy/sclerosis, tubulointerstitial scarring, and arteriosclerosis were statistically significantly and adversely associated with eGFR. Conversely, increasing CCV was associated with a higher eGFR. Conclusions Quantitative analysis of the nephrectomized kidney in conjunction with patient age can accurately predict renal function at 2 years.