First and second generation nephrometry scores for predicting peri- and post-operative results of kidney resection

Česká verzia

Authors: Petr Macek; Maria Stevens; Květoslav Novák; Michael Pešl; Tomáš Hanuš
Authors place of work: Urologická klinika 1. LF UK a VFN v Praze
Published in the journal: Ces Urol 2017; 21(2): 154-160
Category: Original Articles

Summary

Introduction:
Assessment of the first and the second generation nephrometric scores (NS) and their relationship with selected peri- and postoperative results of partial nephrectomies. We tested the correlation of NS with duration of warm ischemia (WI) and estimated glomerular filtration rate (eGF) change in per cent.

Patients and methods:
Prospective assessment of patients undergoing PN between 11/2015 and 6/2016. Tumor size, RENAL, PADUA, DAP scores and C-index as the first-generation NS and NePhRO, SARR a Tobert score as the second-generation NS were tested for correlation with duration of WI and per cent change of eGF.

Results:
We evaluated 35 patients, of which 21 had laparoscopic and 14 open PN. Median and interquartile ranges (IQR) were: age 65 (IQR 52–72), tumor size 35 mm (27–48), RENAL 8 (6–9), PADUA 9 (7–10), DAP 6 (5–7), C index 2.3 (1.6–2.6), NePhRO 9 (7–10), SARR 8 (7–11), Tobert score 7 (3–8), duration of WI 16 min (10–18), per cent change of eGF -5.3 % (-19.1 to -1.5). Duration of WI correlated significantly with tumor size and RENAL, PADUA, DAP, NePhRO, SARR, Tobert scores, and significantly, but inversely with C index. Correlation strength was mild to moderate. In contrast, per cent eGF change correlated significantly with RENAL, PADUA, DAP, NePhRO and SARR scores and tumor size, but not with C-index.

Conclusions:
WI correlated with tumor size and all NS used, but its strength was moderate at best. However, per cent change of eGF, did not correlated with C-index and Tobert score. This is in line with published data about estimated PN difficulty (with WI as surrogate marker), however our data and literature diverge in opinion on functional results. The difference might be due to small cohort size. The main impact of PN scoring systems is in the mutual comparison of PN data and gives us information we may use during counselling.

KEY WORDS:
Partial nephrectomy, nephrometric scores, warm ischemia, estimated glomerular filtration rate.

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