Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores
Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL),...
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| Format: | Article |
| Language: | English |
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Codon Publications
2021-10-01
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| Series: | Journal of Kidney Cancer and VHL |
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| Online Access: | https://www.jkcvhl.com/index.php/jkcvhl/article/view/183 |
| _version_ | 1818367127969595392 |
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| author | Kaan Karamık Yasin Aktaş Ahmet Gürkan Erdemir Ekrem İslamoğlu Mahmut Taha Ölçücü Çağatay Özsoy Murat Savaş Mutlu Ateş |
| author_facet | Kaan Karamık Yasin Aktaş Ahmet Gürkan Erdemir Ekrem İslamoğlu Mahmut Taha Ölçücü Çağatay Özsoy Murat Savaş Mutlu Ateş |
| author_sort | Kaan Karamık |
| collection | DOAJ |
| description | Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL), preoperative aspects and dimensions used for anatomic classifications (PADUA), and centrality index (C-index) nephrometry scores for predicting the strict Trifecta achievement from a single institution series robotic-assisted partial nephrectomy (RAPN). We retrospectively identified the prospectively maintained robotic surgery database records of 91 patients who underwent RAPN between June 2015 and September 2020 in Antalya Training and Research Hospital. The main outcome of the study was the achievement of strict Trifecta (negative surgical margin, no major urologic complications, warm ischemia time ≤25 min, and ≥85% preservation of estimated glomerular filtration rate). A multivariable analysis was performed to identify the factors of strict Trifecta success. The mean patient age was 55.82 ± 13.37 years with a median clinical tumor size of 3.5 cm (IQR 2.5–4.9). The median RENAL, PADUA, and C-index score were 7(IQR 6–8), 8(IQR 7–10), and 2.01(IQR 1.64–2.72), respectively. A strict Trifecta could be achieved in 54 patients (59.3%). Clinical tumor size (P = 0.011), RENAL risk groups (low:reference; intermediate; P = 0.040; high; P = 0.009), PADUA risk groups (low:reference; intermediate; P = 0.044; high; P = 0.001) and C-index risk groups (low:reference; high; P = 0.015) were the independent predictors of strict Trifecta attainment in the multivariate analysis. None of the nephrometry scores were a superior predictor compared to other nephrometry scores in comparative analysis. RENAL, PADUA, and C-index scores were all independent predictors of a strict Trifecta achievement. Our comprehensive comparison of the three scores identified that none of the nephrometry scores proved to be inferior to others nephrometry scores. |
| first_indexed | 2024-12-13T22:47:07Z |
| format | Article |
| id | doaj.art-eac7892872e7422c9c7c281b523e935e |
| institution | Directory Open Access Journal |
| issn | 2203-5826 |
| language | English |
| last_indexed | 2024-12-13T22:47:07Z |
| publishDate | 2021-10-01 |
| publisher | Codon Publications |
| record_format | Article |
| series | Journal of Kidney Cancer and VHL |
| spelling | doaj.art-eac7892872e7422c9c7c281b523e935e2022-12-21T23:28:42ZengCodon PublicationsJournal of Kidney Cancer and VHL2203-58262021-10-018410.15586/jkcvhl.v8i4.183Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index ScoresKaan Karamık0Yasin Aktaş1Ahmet Gürkan Erdemir2Ekrem İslamoğlu3Mahmut Taha Ölçücü4Çağatay Özsoy5Murat Savaş6Mutlu Ateş7Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Department of Urology, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey.Nephrometry scores are designed to characterize tumors and stratify the surgical complexity. It remains unclear as to which nephrometry score can accurately predict the surgical outcomes. We aimed to assess the utility of radius, exophytic/endophytic, nearness, anterior/posterior, location (RENAL), preoperative aspects and dimensions used for anatomic classifications (PADUA), and centrality index (C-index) nephrometry scores for predicting the strict Trifecta achievement from a single institution series robotic-assisted partial nephrectomy (RAPN). We retrospectively identified the prospectively maintained robotic surgery database records of 91 patients who underwent RAPN between June 2015 and September 2020 in Antalya Training and Research Hospital. The main outcome of the study was the achievement of strict Trifecta (negative surgical margin, no major urologic complications, warm ischemia time ≤25 min, and ≥85% preservation of estimated glomerular filtration rate). A multivariable analysis was performed to identify the factors of strict Trifecta success. The mean patient age was 55.82 ± 13.37 years with a median clinical tumor size of 3.5 cm (IQR 2.5–4.9). The median RENAL, PADUA, and C-index score were 7(IQR 6–8), 8(IQR 7–10), and 2.01(IQR 1.64–2.72), respectively. A strict Trifecta could be achieved in 54 patients (59.3%). Clinical tumor size (P = 0.011), RENAL risk groups (low:reference; intermediate; P = 0.040; high; P = 0.009), PADUA risk groups (low:reference; intermediate; P = 0.044; high; P = 0.001) and C-index risk groups (low:reference; high; P = 0.015) were the independent predictors of strict Trifecta attainment in the multivariate analysis. None of the nephrometry scores were a superior predictor compared to other nephrometry scores in comparative analysis. RENAL, PADUA, and C-index scores were all independent predictors of a strict Trifecta achievement. Our comprehensive comparison of the three scores identified that none of the nephrometry scores proved to be inferior to others nephrometry scores.https://www.jkcvhl.com/index.php/jkcvhl/article/view/183C-indexPADUApartial nephrectomyRENALTrifecta |
| spellingShingle | Kaan Karamık Yasin Aktaş Ahmet Gürkan Erdemir Ekrem İslamoğlu Mahmut Taha Ölçücü Çağatay Özsoy Murat Savaş Mutlu Ateş Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores Journal of Kidney Cancer and VHL C-index PADUA partial nephrectomy RENAL Trifecta |
| title | Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores |
| title_full | Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores |
| title_fullStr | Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores |
| title_full_unstemmed | Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores |
| title_short | Predicting Strict Trifecta Outcomes after Robot-Assisted Partial Nephrectomy: Comparison of RENAL, PADUA, and C-Index Scores |
| title_sort | predicting strict trifecta outcomes after robot assisted partial nephrectomy comparison of renal padua and c index scores |
| topic | C-index PADUA partial nephrectomy RENAL Trifecta |
| url | https://www.jkcvhl.com/index.php/jkcvhl/article/view/183 |
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