使用R.E.N.A.L nephrometry, PADUA Classification和Centrality Index Score來進行腎部分切除術後腎功能回復的預測
林鼎博 林文州 張奐光 楊志東 許炯明 周永強 蔡維恭 江百凱 陳建志 李致樵 林文榮
Functional outcome prediction after partial nephrectomy using R.E.N.A.L nephrometry, PADUA classification and centrality index score
Ding-Po Lin, Huang-Kuang Chang, Stone Yang, Jong-Ming Hsu, Yung-Chiong Chow, Wei-Kung Tsai,
Pai-Kai Chiang, Marcelo Chen, Chih-Chiao Lee, Wun-Rong Lin,
Department of Urology, Mackay Memorial Hospital, Taipei, Taiwan
Several scoring system have been proposed to quantify surgical complexity, and provide insight into expected perioperative and postoperative surgical outcomes following partial nephrectomy. However, it is still unclear that which of the scoring system has better outcome in predicting functional outcome after partial nephrectomy. In the present study, we assess the use of R.E.N.A.L., PADUA and centrality index scores to predict the renal function for patients who underwent partial nephrectomy.
Materials and Methods
We retrospectively reviewed 26 cases with renal tumors managed by open partial nephrectomy at our institution from January 2008 to October 2013. R.E.N.A.L., PADUA and centrality index scores were assigned according to the described protocols for those systems. We evaluated the association between scoring systems and both early and late postoperative functional outcome.
The mean age of study population was 56 years old. Of the patients 18 (69%) were male. Mean tumor size was 4.04cm. Each scoring system performed significant correlation with both early and late functional outcome(p<0.05), whereas R.E.N.A.L nephrometry and PADUA classification showed high correlation(-0.715 and -0.721) and centrality index showed moderate correlation(0.451). Single anatomical parameter as diameter of tumor does not correlate with functional outcome significantly. (p=0.974 in one day after surgery and p=0.865 in one year after surgery).
R.E.N.A.L., PADUA and centrality index scores were inversely associated with renal function preservation after partial nephrectomy. In this regard it is possible to use theses scoring systems preoperatively to gauge the magnitude of functional decrease.