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Tumor size and invasiveness matters for partial nephrectomy: External validation and modification of the arterial based complexity score
Author(s) -
Kriegmair Maximilian C.,
Hetjens Svetlana,
Mandel Philipp,
Wadle Jula,
Budjan Johannes,
Michel Maurice S.,
Pfalzgraf Daniel,
Wagener Nina
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24565
Subject(s) - medicine , nephrectomy , logistic regression , renal tumor , multivariate analysis , multivariate statistics , urology , correlation , surgery , clamp , kidney , statistics , mechanical engineering , clamping , geometry , mathematics , engineering
Background Outcome of partial nephrectomy (PN) depends on anatomic features of the renal tumor, which can be assessed by nephrometry scores. The aim was to externally validate and refine the Arterial Based Complexity (ABC) score and to compare it to established systems. Methods Tumors of 300 patients undergoing PN were categorized according to the ABC, RENAL, and PADUA score. Size and tumor invasiveness were combined to form the ABCD score. Correlation analysis and multivariate logistic regression was performed to validate and compare the respective scores as predictors of surgical outcome. Results The ABC score shows significant correlation with ischemia time (IT) ( P < 0.01), opening of the collecting system (CS) ( P < 0.01), and conversion to nephrectomy ( P = 0.01). In the multivariate analysis, the ABC score was predictive for on‐clamp excision ( P < 0.01) and opening of the CS ( P < 0.01) only. The RENAL and ABCD scores were independent predictors for complications ( P = 0.02, P = 0.05), IT ( P < 0.01, P = 0.03), on clamp excision ( P < 0.01, P < 0.01), and opening of the CS ( P < 0.01, P < 0.01). Conclusions The ABC score correlates well with surgical parameters. Expanding the score by tumor diameter gives the ABCD system. It has similar predictive effectiveness to the well‐established RENAL score, but features simplicity by only assessing invasiveness and tumor size.