The association between renal tumour scoring system components and complications of partial nephrectomy

Authors

  • Darren Desantis Department of Surgery, Division of Urology, Ottawa, Ontario
  • Luke Lavallee Department of Surgery, Division of Urology, Ottawa, Ontario
  • Kelsey Witiuk Clinical Epidemiology Program, Ottawa Hospital Research Institute
  • Ranjeeta Mallick Clinical Epidemiology Program, Ottawa Hospital Research Institute
  • Fadi Kamal Department of Surgery, Division of Urology, Ottawa, Ontario
  • Dean Fergusson Clinical Epidemiology Program, Ottawa Hospital Research Institute
  • Christopher Morash Department of Surgery, Division of Urology, Ottawa, Ontario
  • Ilias Cagiannos Department of Surgery, Division of Urology, Ottawa, Ontario
  • Rodney Breau Department of Surgery, Division of Urology, Ottawa, Ontario

DOI:

https://doi.org/10.5489/cuaj.2303

Keywords:

Renal Tumor, Complications, Scoring Systems

Abstract

Introduction: We evaluate the associations between 3 renal tumour scoring systems and their components with perioperative complications of partial nephrectomy.

Methods: A consecutive cohort of partial nephrectomy patients was analyzed. Patient characteristics were abstracted from medical records. PADUA scores (preoperative aspects and dimensions used for anatomic classification), RENAL (radius exophyic/endophytic nearness anterior/posterior location scoring) nephrometry scores, and Centrality index (C-index) were determined from preoperative axial images by 2 independent reviewers. Cases were evaluated for postoperative complications up to 30 days after surgery. Pre-specified complication definitions were used for 33 potential medical and surgical complications. Unadjusted and adjusted associations between overall scores, individual components, and complications were determined using log binomial regression.

Results: In total, 118 patients were included in the study. Of these, 36 (30.5%) surgical complications occurred in 27 (22.9%) patients. Fourteen (11.9%) were Clavien grade ≥3. Overall PADUA score was significantly associated with surgical and overall complications after adjusting for potential confounders. Among all components of the 3 scoring systems, only tumour diameter and exophytic/ endophytic nature of the tumour were significantly associated with complications after adjusting for the other components of the respective scoring system (p < 0.05).

Conclusions: Renal tumour scoring systems may help predict the risk of complications after partial nephrectomy. Further refinement of current systems is required. A first step would be to include only components that are significantly associated with complications.

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Published

2015-02-05

How to Cite

Desantis, D., Lavallee, L., Witiuk, K., Mallick, R., Kamal, F., Fergusson, D., Morash, C., Cagiannos, I., & Breau, R. (2015). The association between renal tumour scoring system components and complications of partial nephrectomy. Canadian Urological Association Journal, 9(1-2), 39–45. https://doi.org/10.5489/cuaj.2303

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Section

Original Research

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