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|Title:||PADUA and RENAL nephrometry scores correlates with perioperative outcomes after robot-assisted partial nephrectomy: analysis of the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI-RUS) database.|
|Epworth Authors:||Moon, Daniel|
|Other Authors:||Schiavina, R.|
La Manna, G.
Renal Cell Carcinoma
Robot Assisted Partial Nephrectomy
Vattikuti Global Quality Initiative in Robotic Urologic Surgery
PADUA Nephrometry Score
RENAL Nephrometry Score
UroRenal, Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
|Citation:||BJU Int. 2016 Aug 16.|
|Abstract:||OBJECTIVES: To evaluate and compare the correlations between PADUA and RENAL scores and perioperative outcomes and postoperative complications in a multicenter, international series of patients undergoing Robot-assisted partial nephrectomy (RAPN) for masses suspicious of RCC. PATIENTS AND METHODS: We retrospectively evaluated the clinical records of patients who underwent RAPN between 2010 and 2013 for clinical N0M0 renal tumours in four international Centers that completed all the data required for the Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI-RUS) database. All patients underwent pre-operative computed tomography or magnetic resonance imaging to define the clinical stage and anatomic characteristics of the tumors. PADUA and RENAL scores were retrospectively assessed in each Center. Univariate and multivariate analyses were performed to evaluate the correlations between age, gender, Charlson comorbidity index, clinical tumor size, PADUA and RENAL complexity group categories and warm ischemia time >20 minutes, urinary calyceal system closure and grade of postoperative complications. RESULTS: Overall, 277 patients have been evaluated. The median tumor size was 33.0 millimeters (22.0-43.0). The median PADUA and RENAL score were 8 and 7 respectively; 112 (40.4%), 86 (31.0%) and 79 (28.5%) patients were classified in the low, intermediate or high-complexity group according to PADUA score, while 118 (42.5%), 139 (50.1%) and 20 (7.2%) were classified in the low, intermediate or high-complexity group according to RENAL score, respectively. Both nephrometric tools significantly correlated with perioperative outcomes at univariate and multivariate analyses. CONCLUSION: A precise stratification of patients before partial nephrectomy is recommended, allowing to balance the potential threats and benefits of nephron-sparing surgery. In our analysis, both PADUA and RENAL were significantly associated with prolonged WIT and high-grade postoperative complications after RAPN.|
|Journal Title:||BJU International|
|Affiliated Organisations:||Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.|
Cardio-Nephro-Thoracic Sciences, University of Bologna, Bologna, Italy.
Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy.
OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium.
Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
Division of Urology and Renal Transplantation, Medanta Kidney and Urology Institute, Medanta, the Medicity, Gurgaon, India.
Dept Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Vic, Australia.
San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
Guy's & St Thomas' NHS Foundation Trust and NIHR Biomedical Research Centre, King's College London, London, UK.
Department of Nephrology and Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
University of Eastern Piedmont, Novara, Italy.
Departments of Radiology, Guy's and St. Thomas' NHS Foundation Trust, King's College London, London, UK.
Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium.
|Type of Clinical Study or Trial:||Retrospective studies|
|Appears in Collections:||Cancer Services|
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