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Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: A retrospective study of 245 patients undergoing laparoscopic partial nephrectomy
Author(s) -
Zhang ZhongYuan,
Tang Qi,
Li XueSong,
Zhang Qian,
Mayer Wesley A,
Wu JingYun,
Yang XueDong,
Zhang XiaoChun,
Wang XiaoYing,
Zhou LiQun
Publication year - 2014
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12192
Subject(s) - medicine , nephrectomy , renal function , renal tumor , urology , perioperative , retrospective cohort study , kidney , pathological , clinical significance , multivariate analysis , surgery
Objective 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 C hinese patients with renal neoplasms undergoing laparoscopic partial nephrectomy from J une 2008 to J une 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.