Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the <scp>RECOR</scp>d 2 project)

Mari, Andrea; Campi, Riccardo; Schiavina, Riccardo; Antonelli, Alessandro; Artibani, Walter; Barale, M.; Bertini, Roberto; Borghesi, Marco; Bove, Pierluigi; Brunocilla, Eugenio; Capitanio, Umberto; Pozzo, L. Da; Daja, Julian; Larcher, Alessandro; Marzi, Vincenzo Li; Longo, Nicola; Mirone, Vincenzo; Montanari, Emanuele; Pisano, Francesca; Porpiglia, Francesco; Simeone, Claudio; Siracusano, Salvatore; Tellini, Riccardo; Trombetta, Carlo; Volpe, Alessandro; Ficarra, Vincenzo; Carini, Marco

doi:10.1111/bju.14680

Cited by 25 publications

(18 citation statements)

References 31 publications

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“…With regard to the clinical implications of these findings, and specifically the role of the nephrometry score in predicting postoperative outcomes, the receiver-operating characteristic curves demonstrated that both the 2D and the 3D nephrometry score were correlated with overall and major complications (AUCs calculated with 3D VMs ranging from 0.67 to 0.84), confirming the findings in the literature [29,30]. Nephrometry category, as assessed by the two different imaging tools, was also considered in order to evaluate whether the 2D-or 3D-based category was more closely related to postoperative outcomes.…”

Section: Discussionsupporting

confidence: 82%

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

et al. 2019

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ObjectivesTo apply the standard PADUA and RENAL nephrometry score variables to three-dimensional (3D) virtual models (VMs) produced from standard bi-dimensional imaging, thereby creating three-dimensional (3D)-based (PADUA and RENAL) nephrometry scores/categories for the reclassification of the surgical complexity of renal masses, and to compare the new 3D nephrometry score/category with the standard 2D-based nephrometry score/category, in order to evaluate their predictive role for postoperative complications. Materials and MethodsAll patients with localized renal tumours scheduled for minimally invasive partial nephrectomy (PN) between September 2016 and September 2018 underwent 3D and 2D nephrometry score/category assessments preoperatively. After nephrometry score/category evaluation, all the patients underwent surgery. Chi-squared tests were used to evaluate the individual patients' grouping on the basis of the imaging tool (3D VMs and 2D imaging) used to assess the nephrometry score/category, while Cohen's j coefficient was used to test the concordance between classifications. Receiver-operating characteristic curves were produced to evaluate the sensitivity and specificity of the 3D nephrometry score/category vs the 2D nephrometry score/ category in predicting the occurrence of postoperative complications. A general linear model was used to perform multivariable analyses to identify predictors of overall and major postoperative complications. ConclusionsIn the present study, we showed that 3D VMs were more precise than 2D standard imaging in evaluating the surgical complexity of renal masses according to nephrometry score/ category. This was attributable to a better perception of tumour depth and its relationships with intrarenal structures using the 3D VM, as confirmed by the higher accuracy of the 3D VM in predicting postoperative complications.Additional Supporting Information may be found in the online version of this article: Table S1. Multivariable analysis identifying the preoperative independent predictors of overall complication and major complications for PADUA and RENAL score. 954

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Section: Discussionsupporting

confidence: 82%

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

et al. 2019

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“…The Italian REgistry of COnservative and Radical surgery for cortical renal tumor Disease (RECORd 2 Project) is a prospective, observational project promoted by the Italian Society of Urology whose collection criteria were previously described [17]. Institutional Review Board approval was obtained for data sharing through the different centers.…”

Section: Methodsmentioning

confidence: 99%

Perioperative Outcomes of Open, Laparoscopic, and Robotic Partial Nephrectomy: A Prospective Multicenter Observational Study (The RECORd 2 Project)

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Larcher

Capitanio

et al. 2021

European Urology Focus

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Background: Partial nephrectomy (PN) has a non-negligible perioperative morbidity. Comparative evidence of the available surgical techniques is limited. Objective: To compare the perioperative outcomes of open, laparoscopic, and robotic PN. Methods: Data of 2331 patients treated with PN for cT1 renal tumors were extracted from the RECORd2 database, a prospective multicenter project. Multivariable regression models assessed the relationship between surgical technique and surgical margins,

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“…years paved the way for the gradually increased employment of minimally invasive approaches, first with the advent of laparoscopy and then with robotics, progressively minimizing the impact and invasiveness of surgical procedures [7][8][9].…”

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Transperitoneal vs retroperitoneal minimally invasive partial nephrectomy: comparison of perioperative outcomes and functional follow-up in a large multi-institutional cohort (The RECORD 2 Project)

et al. 2020

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Background Aim of this study was to evaluate and compare perioperative outcomes of transperitoneal (TP) and retroperitoneal (TR) approaches in a multi-institutional cohort of minimally invasive partial nephrectomy (MI-PN). Material and methods All consecutive patients undergone MI-PN for clinical T1 renal tumors at 26 Italian centers (RECORd2 project) between 01/2013 and 12/2016 were evaluated, collecting the pre-, intra-, and postoperative data. The patients were then stratified according to the surgical approach, TP or RP. A 1:1 propensity score (PS) matching was performed to obtain homogeneous cohorts, considering the age, gender, baseline eGFR, surgical indication, clinical diameter, and PADUA score. Results 1669 patients treated with MI-PN were included in the study, 1256 and 413 undergoing TP and RP, respectively. After 1:1 PS matching according to the surgical access, 413 patients were selected from TP group to be compared with the 413 RP patients. Concerning intraoperative variables, no differences were found between the two groups in terms of surgical approach (lap/robot), extirpative technique (enucleation vs standard PN), hilar clamping, and ischemia time. Conversely, the TP group recorded a shorter median operative time in comparison with the RP group (115 vs 150 min), with a higher occurrence of intraoperative overall, 21 (5.0%) vs 9 (2.1%); p = 0.03, and surgical complications, 18 (4.3%) vs 7 (1.7%); p = 0.04. Concerning postoperative variables, the two groups resulted comparable in terms of complications, positive surgical margins and renal function, even if the RP group recorded a shorter median drainage duration and hospital length of stay (3 vs 2 for both variables), p < 0.0001. Conclusions The results of this study suggest that both TP and RP are feasible approaches when performing MI-PN, irrespectively from tumor location or surgical complexity. Notwithstanding longer operative times, RP seems to have a slighter intraoperative complication rate with earlier postoperative recovery when compared with TP.

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Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

Cited by 25 publications

References 31 publications

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

Three‐dimensional virtual imaging of renal tumours: a new tool to improve the accuracy of nephrometry scores

Perioperative Outcomes of Open, Laparoscopic, and Robotic Partial Nephrectomy: A Prospective Multicenter Observational Study (The RECORd 2 Project)

Transperitoneal vs retroperitoneal minimally invasive partial nephrectomy: comparison of perioperative outcomes and functional follow-up in a large multi-institutional cohort (The RECORD 2 Project)

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