Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
World Journal of Urology
Erschienen in:

26.11.2021 | Original Article

External validation of the Palacios’ equation: a simple and accurate tool to estimate the new baseline renal function after renal cancer surgery

verfasst von: Alessandro Tafuri, Marco Sandri, Alberto Martini, Umberto Capitanio, Guglielmo Mantica, Carlo Terrone, Maria Furlan, Claudio Simeone, Daniele Amparore, Francesco Porpiglia, Andrea Minervini, Andrea Mari, Maria Angela Cerruto, Alessandro Antonelli

Erschienen in: World Journal of Urology | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To externally validate the Palacios’ equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC).

Materials and methods

Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients’ data were used to calculate the predicted NB-GFR through the Palacios’ equation: predicted NB-GFR = 35.03 + 0.65 ∙ preoperative GFR – 18.19 ∙ (if radical nephrectomy) – 0.25 ∙ age + 2.83 ∙ (if tumor size > 7 cm) – 2.09 ∙ (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3–12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin’s concordance correlation coefficient and Bland-Altman analysis.

Results

2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m2 (IQR 56.1–90.1) and 64.2 ml/min/1.73 m2 (IQR 49.6–83); the median predicted NB-GFR was 71.1 ml/min/1.73 m2 (IQR 58–81.5) and 62.6 ml/min/1.73m2 (IQR 47.9–75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m2 in the cohort#1 and #2, respectively. The Palacio’s equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m2 and 35 ml/min/1.73m2 in cohort#1 and #2. The Lin’s concordance correlation coefficient was 0.79 (95% CI 0.77–0.81) and 0.83 (95% CI 0.82–0.85).

Conclusions

We confirm the predictive performances of Palacios’ equation, supporting its utilization in clinical practice.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Siegel RL, Miller KD, Jemal A (2019) Cancer statistics 2019. CA: Cancer J Clin 69(1):7–34
2.
Ljungberg B, Albiges L, Abu-Ghanem Y et al (2019) European association of urology guidelines on renal cell carcinoma: the 2019 update. Eur Urol 75(5):799–810CrossRef
3.
Go AS, Chertow GM, Fan D et al (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351(13):1296–1305CrossRef
4.
Antonelli A, Minervini A, Sandri M et al (2018) Below safety limits, every unit of glomerular filtration rate counts: assessing the relationship between renal function and cancer-specific mortality in renal cell carcinoma. Eur Urol 74(5):661–667CrossRef
5.
Antonelli A, Palumbo C, Sandri M et al (2020) Renal function impairment below safety limits correlates with cancer-specific mortality in localized renal cell carcinoma: results from a single-center study. Clin Genitourin Cancer 18(4):e360–e367CrossRef
6.
7.
Touijer K, Jacqmin D, Kavoussi LR et al (2010) The expanding role of partial nephrectomy: a critical analysis of indications, results, and complications. Eur Urol 57(2):214–222CrossRef
8.
Antonelli A, Furlan M, Tardanico R et al (2017) Features of ipsilateral renal recurrences after partial nephrectomy: a proposal of a pathogenetic classification. Clin Genitourin Cancer 15(5):540–547CrossRef
9.
Sorbellini M, Kattan MW, Snyder ME et al (2006) Prognostic nomogram for renal insufficiency after radical or partial nephrectomy. J Urol 176(2):472–476CrossRef
10.
Kim HL, Shah SK, Tan W et al (2009) Estimation and prediction of renal function in patients with renal tumor. J Urol 181(6):2451–2461CrossRef
11.
Liss MA, DeConde R, Caovan D et al (2016) Parenchymal volumetric assessment as a predictive tool to determine renal function benefit of nephron-sparing surgery compared with radical nephrectomy. J Endourol 30(1):114–121CrossRef
12.
Shum CF, Bahler CD, Cary C et al (2017) Preoperative nomograms for predicting renal function at 1 year after partial nephrectomy. J Endourol 31(7):711–718CrossRef
13.
Martini A, Cumarasamy S, Beksac AT et al (2018) A nomogram to predict significant estimated glomerular filtration rate reduction after robotic partial nephrectomy. Eur Urol 74(6):833–839CrossRef
14.
Bertolo R, Garisto J, Li J et al (2019) Development and internal validation of a nomogram for predicting renal function after partial nephrectomy. Eur Urol Oncol 2(1):106–109CrossRef
15.
Bhindi B, Lohse CM, Schulte PJ et al (2019) Predicting renal function outcomes after partial and radical nephrectomy. Eur Urol 75(5):766–772CrossRef
16.
McIntosh AG, Parker DC, Egleston BL et al (2019) Prediction of significant estimated glomerular filtration rate decline following renal unit removal to aid in the clinical choice between radical and partial nephrectomy in patients with renal mass and normal renal function. BJU Int 124(6):999CrossRef
17.
Antonelli A, Mari A, Longo N et al (2018) Role of clinical and surgical factors for the prediction of immediate, early and late functional results, and its relationship with cardiovascular outcome after partial nephrectomy: results from the prospective multicenter RECORd 1 project. J Urol 199(4):927–932CrossRef
18.
Aguilar Palacios D, Wilson B, Ascha M et al (2021) New baseline renal function after radical or partial nephrectomy: a simple and accurate predictive model. J Urol 205(5):1310–1320CrossRef
19.
Willems JM, Vlasveld T, den Elzen WP et al (2013) Performance of Cockcroft-Gault, MDRD, and CKD-EPI in estimating prevalence of renal function and predicting survival in the oldest old. BMC Geriatr 13(1):113CrossRef
20.
Lawrence I, Lin K (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics 45:255–268CrossRef
21.
Harper WV (2014) Reduced major axis regression. Wiley StatsRef: Statistics Reference Online, p 1–6.
22.
Kim SP, Shah ND, Weight CJ et al (2011) Contemporary trends in nephrectomy for renal cell carcinoma in the United States: results from a population based cohort. J Urol 186(5):1779–1785CrossRef
23.
Bravi CA, Larcher A, Capitanio U et al. (2019) Perioperative outcomes of open, laparoscopic, and robotic partial nephrectomy: a prospective multicenter observational study (The RECORd 2 Project). Eur Urol Focus
24.
25.
Aguilar Palacios D, Caraballo ER, Tanaka H et al (2020) Compensatory changes in parenchymal mass and function after radical nephrectomy. J Urol 204(1):42–49CrossRef
26.
Shinoda K, Morita S, Akita H et al (2019) Preserved kidney volume, body mass index, and age are significant preoperative factors for predicting estimated glomerular filtration rate in living kidney donors at 1 year after donation. Transplantation proceedings. Elsevier
27.
Mir MC, Ercole C, Takagi T et al (2015) Decline in renal function after partial nephrectomy: etiology and prevention. J Urol 193(6):1889–1898CrossRef
28.
Minervini A, Campi R, Kutikov A et al (2015) Histopathological validation of the surface-intermediate-base margin score for standardized reporting of resection technique during nephron sparing surgery. J Urol 194(4):916–922CrossRef
Metadaten
Titel
External validation of the Palacios’ equation: a simple and accurate tool to estimate the new baseline renal function after renal cancer surgery
verfasst von
Alessandro Tafuri
Marco Sandri
Alberto Martini
Umberto Capitanio
Guglielmo Mantica
Carlo Terrone
Maria Furlan
Claudio Simeone
Daniele Amparore
Francesco Porpiglia
Andrea Minervini
Andrea Mari
Maria Angela Cerruto
Alessandro Antonelli
Publikationsdatum
26.11.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 2/2022
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-021-03887-z

Weitere Artikel der Ausgabe 2/2022

The value of procalcitonin for predicting urosepsis after mini-percutaneous nephrolithotomy or flexible ureteroscopy based on different organisms

  • Original Article

Transrectal ultrasound-guided prostate needle biopsy remains a safe method in confirming a prostate cancer diagnosis: a multicentre Australian analysis of infection rates

  • Original Article

Variables measured on three-dimensional computed tomography are preferred for predicting the outcomes of shock wave lithotripsy

  • Original Article

Associations of exposure to polycyclic aromatic hydrocarbons and kidney stones in U.S. general population: results from the National Health and Nutrition Examination Survey 2007–2016

  • Original Article

A prospective comparative study of mini-PCNL using Trilogy™ or thulium fibre laser with suction

  • Original Article

Clinical stage II seminoma: management options

  • Topic Paper

Neu im Fachgebiet Urologie

Adjuvanter PD-L1-Hemmer verhindert Rezidive bei Hochrisiko-Urothelkarzinom

Sind Menschen mit muskelinvasivem Urothelkarzinom für die neoadjuvante platinbasierte Therapie nicht geeignet oder sprechen sie darauf nicht gut an, ist Pembrolizumab eine adjuvante Alternative: Die krankheitsfreie Lebenszeit wird dadurch mehr als verdoppelt.

Nierenzellkarzinom: Kein Nachteil durch subkutan appliziertes Nivolumab

Die subkutane Applikation von Nivolumab ist nach Daten einer Phase-3-Studie ähnlich gut wirksam wie die intravenöse: Die Pharmakokinetik ist vergleichbar, die objektive Response war in der Studie sogar leicht besser als in der Gruppe mit Infusionen.

Auf weichem Fahrradsattel ist nicht gut Kinder zeugen

Männer, die sich gern sportlich verausgaben, riskieren möglicherweise, fürs Vaterwerden nicht genug Kräfte übrig zu haben. In einer Studie fanden sich dafür zwar allenfalls schwache Anzeichen. Es gab jedoch eine Ausnahme.

Vorteile für Androgenentzug plus Androgenrezeptorblockade

Für Männer mit metastasiertem hormonsensitivem Prostata-Ca. (mHSPC), die keine Hormonchemotherapie wollen oder vertragen, ist der Androgenentzug plus Darolutamid eine Alternative: Das Progressionsrisiko wird im Vergleich zum alleinigen Androgenentzug fast halbiert.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise