Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: A retrospective study of 245 patients undergoing laparoscopic partial nephrectomy

Abstract

Abbreviations & AcronymsObjective: To investigate the clinical significance of preoperative aspects and dimensions used for anatomic (PADUA) and radius exophytic/endophytic nearness anterior/posterior location (RENAL) scoring systems for renal neoplasms in patients undergoing laparoscopic partial nephrectomy. Methods: A retrospective analysis was carried out on clinical data of 245 Chinese patients with renal neoplasms undergoing laparoscopic partial nephrectomy from June 2008 to June 2012. The perioperative complications and variables, as well as PADUA and RENAL score, were compared. Results: The PADUA and RENAL scoring systems were significantly associated with percent change in estimated glomerular filtration rate (P = 0.032 and P = 0.026 respectively), whereas the RENAL scoring system was also significantly associated with warm ischemia time (P = 0.032). On multivariate analysis, both scores were able to predict percent change in estimated glomerular filtration rate (PADUA, P = 0.011; RENAL, P = 0.028). There were no significant associations between the two scoring systems assessed and the occurrence of complications or tumor stage. The correlation between PADUA classification and RENAL nephrometry score was significant (P < 0.0001). Fleiss' generalized kappa was 0.69-0.89 for the various components of the PADUA score and 0.67-0.89 for the RENAL nephrometry components. Conclusions:The PADUA classification and RENAL nephrometry score are comprehensive assessment tools for delineating renal tumor anatomy. The reproducibility of the PADUA and RENAL scores is substantial, but further research is required to evaluate its performance in more accurately predicting operative and patient-related outcomes.

PADUA and R.E.N.A.L. nephrometry scores correlate with perioperative outcomes of robot‐assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI‐RUS) database

“…The same group stratification was shown to be independently associated with perioperative complications. Long et al [28] [30] analysed the correlations between the two scoring systems and both WIT and perioperative complications. In their series of 245 patients treated with laparoscopic PN, they found that only the R.E.N.A.L.…”

Laparoscopic radical and partial nephrectomy: The clinical efficacy and acceptance of the techniques

“…Moreover, these systems allow a consensus in the evaluation of tumors among surgeons. [28] The evaluation of these scores showed that there is not any significant difference among the scoring systems and tumor stage or perioperative complications. [2829] Pre-operative aspects and dimensions used for an anatomical score ≥ 10 and RENAL score ≥9 are factors demonstrating a high risk for perioperative complications.…”

“…[28] The evaluation of these scores showed that there is not any significant difference among the scoring systems and tumor stage or perioperative complications. [2829] Pre-operative aspects and dimensions used for an anatomical score ≥ 10 and RENAL score ≥9 are factors demonstrating a high risk for perioperative complications. [30] An increasing RENAL score is associated with histological features of tumor aggressiveness and a greater proportion of major complications.…”

Surgeon-specific factors affecting treatment decisions among Canadian urologists in the management of pT1a renal tumours

“…nephrometry and PADUA scores, have been developed to help predict the risk of surgical complications and postoperative renal function. [16][17][18][19][20][21][22] Despite these guidelines and scoring systems, a lack of consensus often exists among urologists when different treatment options are presented for the same patient. While much of the discussion may focus around patient and diseasespecific factors, a variety of surgeon-specific factors may also influence treatment decisions.…”