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The role of RENAL, PADUA, C-index, CSA nephrometry systems in predicting ipsilateral renal function after partial nephrectomy
Functional outcome is an important issue in nephron-sparing surgery. Various nephrometries have been developed to predict renal function preservation. The aim of this study was to examine the applicability of R.E.N.A.L., PADUA, C-index, and mathematical tumor contact surface area (CSA) in predicting...
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| Published in: | BMC urology 2019-08, Vol.19 (1), p.72-72, Article 72 |
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| description | Functional outcome is an important issue in nephron-sparing surgery. Various nephrometries have been developed to predict renal function preservation. The aim of this study was to examine the applicability of R.E.N.A.L., PADUA, C-index, and mathematical tumor contact surface area (CSA) in predicting ipsilateral renal function after partial nephrectomy using radio-isotope scans.
We performed this retrospective study in patients who underwent partial nephrectomy between May 2013 and April 2017, and used abdominopelvic computerized tomography or magnetic resonance imaging to obtain R.E.N.A.L., C-index, and CSA. Renal function was measured by 99mTc mercaptoacetyltriglycine (MAG3). We evaluated correlations between nephrometries and perioperative parameters, and comparatively analyzed different nephrometries to determine the predictive ability in the percent change of effective renal plasma flow of the affected kidney.
Three, two, and 35 patients received partial nephrectomy in open, laparoscopic, and robotic approaches, respectively. The median (IQR) tumor size was 3.13 (2.4) cm. The median (IQR) R.E.N.A.L., PADUA, C-index, and CSA scores were 7 (3), 8 (2), 2.01 (1.87), and 14.14 (19.25) cm
, respectively. Spearman correlation analysis showed that four nephrometries were correlated with each other. The strongest correlations were between CSA and C-index (coefficient: - 0.885, p |
| doi_str_mv | 10.1186/s12894-019-0504-2 |
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We performed this retrospective study in patients who underwent partial nephrectomy between May 2013 and April 2017, and used abdominopelvic computerized tomography or magnetic resonance imaging to obtain R.E.N.A.L., C-index, and CSA. Renal function was measured by 99mTc mercaptoacetyltriglycine (MAG3). We evaluated correlations between nephrometries and perioperative parameters, and comparatively analyzed different nephrometries to determine the predictive ability in the percent change of effective renal plasma flow of the affected kidney.
Three, two, and 35 patients received partial nephrectomy in open, laparoscopic, and robotic approaches, respectively. The median (IQR) tumor size was 3.13 (2.4) cm. The median (IQR) R.E.N.A.L., PADUA, C-index, and CSA scores were 7 (3), 8 (2), 2.01 (1.87), and 14.14 (19.25) cm
, respectively. Spearman correlation analysis showed that four nephrometries were correlated with each other. The strongest correlations were between CSA and C-index (coefficient: - 0.885, p < 0.001), followed by R.E.N.A.L. and PADUA (coefficient: 0.778, p < 0.001). Ischemia time was significantly correlated with R.EN.A.L. (coefficient: 0.35, p = 0.025), PADUA (coefficient: 0.42, p = 0.007), C-index (coefficient: - 0.45, p = 0.004), and CSA (coefficient: 0.41, p = 0.009). In multivariate analysis, PADUA significantly affected ischemia time (p = 0.04). The percent change in effective renal plasma flow (PCE) of the operated kidney was correlated with PADUA (coefficient: 0.48 p = 0.002), C-index (coefficient: - 0.74, p < 0.001), and CSA (coefficient: 0.75, p < 0.001). Only CSA and C-index independently affected PCE (both p < 0.05) in multivariate analysis. In ROC curve analysis, both C-index and CSA could predict 20% change in effective renal plasma flow (AUC: 0.91 vs 0.86, p = 0.2) of the affected kidney.
We suggest using PADUA to evaluate surgical complexity and ischemia time. Regarding the accuracy of the prediction of post-operative ipsilateral renal function, both CSA and C-index outperformed R.E.N.A.L. and PADUA nephrometries.</description><identifier>ISSN: 1471-2490</identifier><identifier>EISSN: 1471-2490</identifier><identifier>DOI: 10.1186/s12894-019-0504-2</identifier><identifier>PMID: 31382944</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Aged ; CAT scans ; Comparative analysis ; Contact surface area ; Diagnostic imaging ; Female ; Humans ; Ischemia ; Kidney - diagnostic imaging ; Kidney - physiology ; Kidney - surgery ; Kidney Function Tests ; Kidney Neoplasms - diagnostic imaging ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Magnetic Resonance Imaging ; Male ; Medical research ; Middle Aged ; Nephrectomy ; Nephrectomy - methods ; Nephrometry ; Partial nephrectomy ; Patient outcomes ; Prognosis ; Renal function ; Renal scintigraphy ; Retrospective Studies ; Surgery ; Tomography ; Tomography, X-Ray Computed ; Tumors</subject><ispartof>BMC urology, 2019-08, Vol.19 (1), p.72-72, Article 72</ispartof><rights>COPYRIGHT 2019 BioMed Central Ltd.</rights><rights>The Author(s). 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-37cacdc9d6f9d283b245ad96406c52d1835dda5321d7c6711afef2b68eacf91a3</citedby><cites>FETCH-LOGICAL-c532t-37cacdc9d6f9d283b245ad96406c52d1835dda5321d7c6711afef2b68eacf91a3</cites><orcidid>0000-0002-0339-5226</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683378/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683378/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31382944$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Yu-De</creatorcontrib><creatorcontrib>Huang, Chi-Ping</creatorcontrib><creatorcontrib>Chang, Chao-Hsiang</creatorcontrib><creatorcontrib>Wu, Hsi-Chin</creatorcontrib><creatorcontrib>Yang, Che-Rei</creatorcontrib><creatorcontrib>Wang, Yu-Ping</creatorcontrib><creatorcontrib>Hsieh, Po-Fan</creatorcontrib><title>The role of RENAL, PADUA, C-index, CSA nephrometry systems in predicting ipsilateral renal function after partial nephrectomy</title><title>BMC urology</title><addtitle>BMC Urol</addtitle><description>Functional outcome is an important issue in nephron-sparing surgery. Various nephrometries have been developed to predict renal function preservation. The aim of this study was to examine the applicability of R.E.N.A.L., PADUA, C-index, and mathematical tumor contact surface area (CSA) in predicting ipsilateral renal function after partial nephrectomy using radio-isotope scans.
We performed this retrospective study in patients who underwent partial nephrectomy between May 2013 and April 2017, and used abdominopelvic computerized tomography or magnetic resonance imaging to obtain R.E.N.A.L., C-index, and CSA. Renal function was measured by 99mTc mercaptoacetyltriglycine (MAG3). We evaluated correlations between nephrometries and perioperative parameters, and comparatively analyzed different nephrometries to determine the predictive ability in the percent change of effective renal plasma flow of the affected kidney.
Three, two, and 35 patients received partial nephrectomy in open, laparoscopic, and robotic approaches, respectively. The median (IQR) tumor size was 3.13 (2.4) cm. The median (IQR) R.E.N.A.L., PADUA, C-index, and CSA scores were 7 (3), 8 (2), 2.01 (1.87), and 14.14 (19.25) cm
, respectively. Spearman correlation analysis showed that four nephrometries were correlated with each other. The strongest correlations were between CSA and C-index (coefficient: - 0.885, p < 0.001), followed by R.E.N.A.L. and PADUA (coefficient: 0.778, p < 0.001). Ischemia time was significantly correlated with R.EN.A.L. (coefficient: 0.35, p = 0.025), PADUA (coefficient: 0.42, p = 0.007), C-index (coefficient: - 0.45, p = 0.004), and CSA (coefficient: 0.41, p = 0.009). In multivariate analysis, PADUA significantly affected ischemia time (p = 0.04). The percent change in effective renal plasma flow (PCE) of the operated kidney was correlated with PADUA (coefficient: 0.48 p = 0.002), C-index (coefficient: - 0.74, p < 0.001), and CSA (coefficient: 0.75, p < 0.001). Only CSA and C-index independently affected PCE (both p < 0.05) in multivariate analysis. In ROC curve analysis, both C-index and CSA could predict 20% change in effective renal plasma flow (AUC: 0.91 vs 0.86, p = 0.2) of the affected kidney.
We suggest using PADUA to evaluate surgical complexity and ischemia time. Regarding the accuracy of the prediction of post-operative ipsilateral renal function, both CSA and C-index outperformed R.E.N.A.L. and PADUA nephrometries.</description><subject>Aged</subject><subject>CAT scans</subject><subject>Comparative analysis</subject><subject>Contact surface area</subject><subject>Diagnostic imaging</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - physiology</subject><subject>Kidney - surgery</subject><subject>Kidney Function Tests</subject><subject>Kidney Neoplasms - diagnostic imaging</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Nephrectomy</subject><subject>Nephrectomy - methods</subject><subject>Nephrometry</subject><subject>Partial nephrectomy</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Renal function</subject><subject>Renal scintigraphy</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tomography</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><issn>1471-2490</issn><issn>1471-2490</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNptkt9rFDEQxxdRbK3-Ab5IwBcfujU_drPJi7CcVQtFRdvnkEsmdym7yTbZE-_B_91cr5YeSCAZZr7zYSZ8q-o1wWeECP4-EypkU2Mia9zipqZPqmPSdKSmjcRPH8VH1YucbzAmnWj58-qIESaobJrj6s_VGlCKA6Do0I_zr_3lKfref7zuT9Gi9sHC7xL87FGAaZ3iCHPaorzNM4wZ-YCmBNab2YcV8lP2g54h6QElCOV2m1BKMSDtShpNOs2-pO9QYOY4bl9Wz5weMry6f0-q60_nV4sv9eW3zxeL_rI2LaNzzTqjjTXScictFWxJm1ZbyRvMTUstEay1VhcpsZ3hHSHagaNLLkAbJ4lmJ9XFnmujvlFT8qNOWxW1V3eJmFZqN5wZQFnX2kYICUbqpimf1zaSMzCYAFkKhwvrw541bZYjWANhLisfQA8rwa_VKv5SnAvGOlEA7-4BKd5uIM9q9NnAMOgAcZMVpVxIJnAni_TtXrrSZTQfXCxEs5OrvpW8lYTjHfDsP6pyLIzexADOl_xBA9k3mBRzTuAepidY7Zyl9s5SxVlq5yxFS8-bx2s_dPyzEvsLUtfJhQ</recordid><startdate>20190805</startdate><enddate>20190805</enddate><creator>Wang, Yu-De</creator><creator>Huang, Chi-Ping</creator><creator>Chang, Chao-Hsiang</creator><creator>Wu, Hsi-Chin</creator><creator>Yang, Che-Rei</creator><creator>Wang, Yu-Ping</creator><creator>Hsieh, Po-Fan</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-0339-5226</orcidid></search><sort><creationdate>20190805</creationdate><title>The role of RENAL, PADUA, C-index, CSA nephrometry systems in predicting ipsilateral renal function after partial nephrectomy</title><author>Wang, Yu-De ; Huang, Chi-Ping ; Chang, Chao-Hsiang ; Wu, Hsi-Chin ; Yang, Che-Rei ; Wang, Yu-Ping ; Hsieh, Po-Fan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-37cacdc9d6f9d283b245ad96406c52d1835dda5321d7c6711afef2b68eacf91a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>CAT scans</topic><topic>Comparative analysis</topic><topic>Contact surface area</topic><topic>Diagnostic imaging</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - physiology</topic><topic>Kidney - surgery</topic><topic>Kidney Function Tests</topic><topic>Kidney Neoplasms - diagnostic imaging</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - surgery</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Nephrectomy</topic><topic>Nephrectomy - methods</topic><topic>Nephrometry</topic><topic>Partial nephrectomy</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Renal function</topic><topic>Renal scintigraphy</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tomography</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Yu-De</creatorcontrib><creatorcontrib>Huang, Chi-Ping</creatorcontrib><creatorcontrib>Chang, Chao-Hsiang</creatorcontrib><creatorcontrib>Wu, Hsi-Chin</creatorcontrib><creatorcontrib>Yang, Che-Rei</creatorcontrib><creatorcontrib>Wang, Yu-Ping</creatorcontrib><creatorcontrib>Hsieh, Po-Fan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>BMC urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Yu-De</au><au>Huang, Chi-Ping</au><au>Chang, Chao-Hsiang</au><au>Wu, Hsi-Chin</au><au>Yang, Che-Rei</au><au>Wang, Yu-Ping</au><au>Hsieh, Po-Fan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of RENAL, PADUA, C-index, CSA nephrometry systems in predicting ipsilateral renal function after partial nephrectomy</atitle><jtitle>BMC urology</jtitle><addtitle>BMC Urol</addtitle><date>2019-08-05</date><risdate>2019</risdate><volume>19</volume><issue>1</issue><spage>72</spage><epage>72</epage><pages>72-72</pages><artnum>72</artnum><issn>1471-2490</issn><eissn>1471-2490</eissn><abstract>Functional outcome is an important issue in nephron-sparing surgery. Various nephrometries have been developed to predict renal function preservation. The aim of this study was to examine the applicability of R.E.N.A.L., PADUA, C-index, and mathematical tumor contact surface area (CSA) in predicting ipsilateral renal function after partial nephrectomy using radio-isotope scans.
We performed this retrospective study in patients who underwent partial nephrectomy between May 2013 and April 2017, and used abdominopelvic computerized tomography or magnetic resonance imaging to obtain R.E.N.A.L., C-index, and CSA. Renal function was measured by 99mTc mercaptoacetyltriglycine (MAG3). We evaluated correlations between nephrometries and perioperative parameters, and comparatively analyzed different nephrometries to determine the predictive ability in the percent change of effective renal plasma flow of the affected kidney.
Three, two, and 35 patients received partial nephrectomy in open, laparoscopic, and robotic approaches, respectively. The median (IQR) tumor size was 3.13 (2.4) cm. The median (IQR) R.E.N.A.L., PADUA, C-index, and CSA scores were 7 (3), 8 (2), 2.01 (1.87), and 14.14 (19.25) cm
, respectively. Spearman correlation analysis showed that four nephrometries were correlated with each other. The strongest correlations were between CSA and C-index (coefficient: - 0.885, p < 0.001), followed by R.E.N.A.L. and PADUA (coefficient: 0.778, p < 0.001). Ischemia time was significantly correlated with R.EN.A.L. (coefficient: 0.35, p = 0.025), PADUA (coefficient: 0.42, p = 0.007), C-index (coefficient: - 0.45, p = 0.004), and CSA (coefficient: 0.41, p = 0.009). In multivariate analysis, PADUA significantly affected ischemia time (p = 0.04). The percent change in effective renal plasma flow (PCE) of the operated kidney was correlated with PADUA (coefficient: 0.48 p = 0.002), C-index (coefficient: - 0.74, p < 0.001), and CSA (coefficient: 0.75, p < 0.001). Only CSA and C-index independently affected PCE (both p < 0.05) in multivariate analysis. In ROC curve analysis, both C-index and CSA could predict 20% change in effective renal plasma flow (AUC: 0.91 vs 0.86, p = 0.2) of the affected kidney.
We suggest using PADUA to evaluate surgical complexity and ischemia time. Regarding the accuracy of the prediction of post-operative ipsilateral renal function, both CSA and C-index outperformed R.E.N.A.L. and PADUA nephrometries.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>31382944</pmid><doi>10.1186/s12894-019-0504-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-0339-5226</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged CAT scans Comparative analysis Contact surface area Diagnostic imaging Female Humans Ischemia Kidney - diagnostic imaging Kidney - physiology Kidney - surgery Kidney Function Tests Kidney Neoplasms - diagnostic imaging Kidney Neoplasms - pathology Kidney Neoplasms - surgery Magnetic Resonance Imaging Male Medical research Middle Aged Nephrectomy Nephrectomy - methods Nephrometry Partial nephrectomy Patient outcomes Prognosis Renal function Renal scintigraphy Retrospective Studies Surgery Tomography Tomography, X-Ray Computed Tumors |
| title | The role of RENAL, PADUA, C-index, CSA nephrometry systems in predicting ipsilateral renal function after partial nephrectomy |
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