Erschienen in:
01.04.2015 | Original Article
Comparison of diameter-axial-polar nephrometry and RENAL nephrometry score for treatment decision-making in patients with small renal mass
verfasst von:
Yoshio Naya, Akihiro Kawauchi, Masakatu Oishi, Takashi Ueda, Atsuko Fujihara, Yasuyuki Naito, Terukazu Nakamura, Fumiya Hongo, Kazumi Kamoi, Koji Okihara, Tsuneharu Miki
Erschienen in:
International Journal of Clinical Oncology
|
Ausgabe 2/2015
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Abstract
Introduction
The aim of this study was to evaluate our institution’s experience in performing laparoscopic radical nephrectomy (LRN) and partial nephrectomy (PN) in patients with small renal masses.
Methods
142 patients with cT1aN0M0 lesions were identified. 68 of these subjects were treated with LRN and 74 were treated with laparoscopic PN (LPN). The clinicopathological characteristics of the two groups of patients, including diameter-axial-polar (DAP) nephrometry and RENAL nephrometry score (RENAL-NS), operative results, and outcomes, were retrospectively analyzed.
Results
A multivariate logistic regression analysis for the selection of PN as the treatment showed that tumor size, DAP nephrometry, RENAL-NS and imperative condition were all independent factors. The area under the curve receiver operating characteristics (ROC-AUC) of DAP and RENAL-NS for performing LPN were 0.897 and 0.825, respectively.
Conclusions
Although LRN was performed in patients with a high nephrometry score in this study, open partial nephrectomy (OPN) should be considered for patients with a high nephrometry score in T1a renal cell carcinoma (RCC) because of better functional and similar oncological outcomes. Based on ROC analysis, when DAP is 6 or less, LPN should be considered and when DAP is 7 or more, OPN should be considered.