Comparison of diameter-axial-polar nephrometry score and RENAL nephrometry score for surgical outcomes following laparoscopic partial nephrectomy

• Published in: International journal of urology Vol. 23; no. 2; pp. 148 - 152
• Main Authors: Yoshida, Kenji, Kinoshita, Hidefumi, Yoshida, Takashi, Takayasu, Kenta, Mishima, Takao, Yanishi, Masaaki, Komai, Yoshihiro, Sugi, Motohiko, Kawa, Gen, Matsuda, Tadashi
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.02.2016
• Subjects: anatomical pathological conditions; Glomerular Filtration Rate; Humans; Kidney; Kidney Neoplasms - surgery; Laparoscopy; Nephrectomy; outcomes research; Retrospective Studies; Treatment Outcome; warm ischemia; laparoscopy; warm ischemia; nephrectomy; anatomical pathological conditions; outcomes research
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.13009

Objectives To compare diameter–axial–polar nephrometry score with RENAL nephrometry score for surgical outcomes after laparoscopic partial nephrectomy. Methods We retrospectively reviewed data from 134 patients who underwent laparoscopic partial nephrectomy, using diameter–axial–polar and RENAL scores. We analyzed data for warm ischemic time and estimated blood loss intraoperatively, and percentage change in estimated glomerular filtration rate 6 months and 1 year postoperatively. Both scores were classified as low‐, middle‐ and high‐risk, and were used to compare the three analyzed parameters. Results The median tumor size was 2.3 cm (range 1.0–5.4 cm); warm ischemic time was 25.4 min (range 6.5–57 min); and at 6 months and 1 year, percentage change in estimated glomerular filtration rate was 93% (range 51.7–133.3%) and 91% (range 49.4–137.6%), respectively. There were no significant differences in warm ischemic time and estimated blood loss for RENAL between risk groups (P = 0.38 and 0.09, respectively), but significant differences between groups for diameter–axial–polar score (P = 0.02 and 0.01, respectively). There were no significant differences in either score between groups for percentage change in estimated glomerular filtration rate at 6 months and 1 year. A total of 27 high‐risk cases with a diameter–axial–polar score of seven points underwent laparoscopic partial nephrectomy safely; all three cases with a diameter–axial–polar score of eight points were converted to open partial nephrectomy. Conclusions Diameter–axial–polar score seems to estimate the complexity of tumor characteristics in patients undergoing laparoscopic partial nephrectomy better than RENAL score. It has a better correlation with warm ischemic time and estimated blood loss.