Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy

Abstract There are several nephrometry scoring systems for predicting surgical complexity and potential perioperative morbidity. The R.E.N.A.L. scoring system, one of the most well-known nephrometry scoring systems, emphasizes the features on which it is based (Radius, Exophytic/endophytic, Nearness...

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Autores principales:	Haruyuki Ohsugi, Kyojiro Akiyama, Hisanori Taniguchi, Masaaki Yanishi, Motohiko Sugi, Tadashi Matsuda, Hidefumi Kinoshita
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/40eb07d1a15d47438ecb7951c5a129af
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spelling	oai:doaj.org-article:40eb07d1a15d47438ecb7951c5a129af2021-11-21T12:17:51ZTumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy10.1038/s41598-021-01539-12045-2322https://doaj.org/article/40eb07d1a15d47438ecb7951c5a129af2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-01539-1https://doaj.org/toc/2045-2322Abstract There are several nephrometry scoring systems for predicting surgical complexity and potential perioperative morbidity. The R.E.N.A.L. scoring system, one of the most well-known nephrometry scoring systems, emphasizes the features on which it is based (Radius, Exophytic/endophytic, Nearness to collecting system or sinus, Anterior/posterior, and Location relative to polar lines). The ability of these nephrometry scoring systems to predict loss of renal function after robotic partial nephrectomy (RPN) remains controversial. Therefore, we verified which combination of factors from nephrometry scoring systems, including tumor volume, was the most significant predictor of postoperative renal function. Patients who underwent RPN for cT1 renal tumors in our hospital were reviewed retrospectively (n = 163). The preoperative clinical data (estimated glomerular filtration rate [eGFR], comorbidities, and nephrometry scoring systems including R.E.N.A.L.) and perioperative outcomes were evaluated. We also calculated the tumor volume using the equation applied to an ellipsoid by three-dimensional computed tomography. The primary outcome was reduced eGFR, which was defined as an eGFR reduction of ≥ 20% from baseline to 6 months after RPN. Multivariable logistic regression analyses were used to evaluate the relationships between preoperative variables and reduced eGFR. Of 163 patients, 24 (14.7%) had reduced eGFR. Multivariable analyses indicated that tumor volume (cutoff value ≥ 14.11 cm3, indicating a sphere with a diameter ≥ approximately 3 cm) and tumor crossing of the axial renal midline were independent factors associated with a reduced eGFR (odds ratio [OR] 4.57; 95% confidence interval [CI] 1.69–12.30; P = 0.003 and OR 3.50; 95% CI 1.30–9.46; P = 0.034, respectively). Our classification system using these two factors showed a higher area under the receiver operating characteristic curve (AUC) than previous nephrometry scoring systems (AUC = 0.786 vs. 0.653–0.719), and it may provide preoperative information for counseling patients about renal function after RPN.Haruyuki OhsugiKyojiro AkiyamaHisanori TaniguchiMasaaki YanishiMotohiko SugiTadashi MatsudaHidefumi KinoshitaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Haruyuki Ohsugi Kyojiro Akiyama Hisanori Taniguchi Masaaki Yanishi Motohiko Sugi Tadashi Matsuda Hidefumi Kinoshita Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
description	Abstract There are several nephrometry scoring systems for predicting surgical complexity and potential perioperative morbidity. The R.E.N.A.L. scoring system, one of the most well-known nephrometry scoring systems, emphasizes the features on which it is based (Radius, Exophytic/endophytic, Nearness to collecting system or sinus, Anterior/posterior, and Location relative to polar lines). The ability of these nephrometry scoring systems to predict loss of renal function after robotic partial nephrectomy (RPN) remains controversial. Therefore, we verified which combination of factors from nephrometry scoring systems, including tumor volume, was the most significant predictor of postoperative renal function. Patients who underwent RPN for cT1 renal tumors in our hospital were reviewed retrospectively (n = 163). The preoperative clinical data (estimated glomerular filtration rate [eGFR], comorbidities, and nephrometry scoring systems including R.E.N.A.L.) and perioperative outcomes were evaluated. We also calculated the tumor volume using the equation applied to an ellipsoid by three-dimensional computed tomography. The primary outcome was reduced eGFR, which was defined as an eGFR reduction of ≥ 20% from baseline to 6 months after RPN. Multivariable logistic regression analyses were used to evaluate the relationships between preoperative variables and reduced eGFR. Of 163 patients, 24 (14.7%) had reduced eGFR. Multivariable analyses indicated that tumor volume (cutoff value ≥ 14.11 cm3, indicating a sphere with a diameter ≥ approximately 3 cm) and tumor crossing of the axial renal midline were independent factors associated with a reduced eGFR (odds ratio [OR] 4.57; 95% confidence interval [CI] 1.69–12.30; P = 0.003 and OR 3.50; 95% CI 1.30–9.46; P = 0.034, respectively). Our classification system using these two factors showed a higher area under the receiver operating characteristic curve (AUC) than previous nephrometry scoring systems (AUC = 0.786 vs. 0.653–0.719), and it may provide preoperative information for counseling patients about renal function after RPN.
format	article
author	Haruyuki Ohsugi Kyojiro Akiyama Hisanori Taniguchi Masaaki Yanishi Motohiko Sugi Tadashi Matsuda Hidefumi Kinoshita
author_facet	Haruyuki Ohsugi Kyojiro Akiyama Hisanori Taniguchi Masaaki Yanishi Motohiko Sugi Tadashi Matsuda Hidefumi Kinoshita
author_sort	Haruyuki Ohsugi
title	Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
title_short	Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
title_full	Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
title_fullStr	Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
title_full_unstemmed	Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
title_sort	tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/40eb07d1a15d47438ecb7951c5a129af
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Tumor volume and tumor crossing of the axial renal midline predict renal function after robotic partial nephrectomy

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