536 PADUA SCORE ACCURATELY PREDICTS THE RISK OF COMPLICATION AND ISCHEMIC TIME IN PATIENTS WHO ARE CANDIDATES FOR NEPHRON SPARING SURGERY

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging1 Apr 2011536 PADUA SCORE ACCURATELY PREDICTS THE RISK OF COMPLICATION AND ISCHEMIC TIME IN PATIENTS WHO ARE CANDIDATES FOR NEPHRON SPARING SURGERY Roscigno Marco, Rayan Matloob, Maria Nicolai, Elena Strada, Giovanni Petralia, Federico Deho, Francesco Sozzi, Gianfranco Deiana, Roberto Bertini, and Luigi Filippo da Pozzo Roscigno MarcoRoscigno Marco Bergamo, Italy More articles by this author , Rayan MatloobRayan Matloob Milan, Italy More articles by this author , Maria NicolaiMaria Nicolai Bergamo, Italy More articles by this author , Elena StradaElena Strada Milan, Italy More articles by this author , Giovanni PetraliaGiovanni Petralia Milan, Italy More articles by this author , Federico DehoFederico Deho Bergamo, Italy More articles by this author , Francesco SozziFrancesco Sozzi Milan, Italy More articles by this author , Gianfranco DeianaGianfranco Deiana Bergamo, Italy More articles by this author , Roberto BertiniRoberto Bertini Milan, Italy More articles by this author , and Luigi Filippo da PozzoLuigi Filippo da Pozzo Bergamo, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1260AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES to prospectively test the Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification in a cohort of patients submitted to open nephron sparing surgery (NSS) and to correlate the PADUA score to ischemia time. METHODS from December 2009 and September 2010, 112 consecutive patients were treated with open NSS with the technique of hilar arterial clamping. Tumor were reclassified according to the PADUA classification. Complication were graded according to the modified Clavien system. Univariable and multivariable logistic regression analyses tested the predictive value of PADUA score on overall complication rate and on the ischemic time. RESULTS Sixty-one patients underwent extraperitoneal NSS through a flank incision, while 51 patients underwent transperitoneal approach. Mean patients age was 61.8 °À 13.3 years. The median tumor diameter was 3.4–1.5 cm. The median PADUA score was 8 (range 6–13). Mean ischemia time was 20–10 min. Overall complication rate was 18.7% (n=21). On univariable analysis, the PADUA score correlated with complication rate (p=0.027) and with increased ischemia time, considered as a continuous variable as well as categorical one (°Ü 25 min vs < 25 min) (p < 0.001 and p= 0.03, respectively). On multivariable analysis PADUA score achieved the independent predictor status of complication rate, after adjusting for body mass index and surgical approach. Patients with PADUA score 8–9 had a 4-fold risk of complication, while patients with PADUA score > 10 had a 15-fold risk compared to those with scores of 6–7 (p=0.013). Moreover. patients with PADUA score >10 had a 6-fold risk of ischemic time > 25 minutes (p=0.002). CONCLUSIONS our study confirms that PADUA score can reliably predict risk complication and ischemic time in patients treated with NSS, independently from the extra or transperitoneal approach. PADUA classification can help the selection of patients who may benefit from additional techniques such as hypothermic procedure. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e218 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roscigno Marco Bergamo, Italy More articles by this author Rayan Matloob Milan, Italy More articles by this author Maria Nicolai Bergamo, Italy More articles by this author Elena Strada Milan, Italy More articles by this author Giovanni Petralia Milan, Italy More articles by this author Federico Deho Bergamo, Italy More articles by this author Francesco Sozzi Milan, Italy More articles by this author Gianfranco Deiana Bergamo, Italy More articles by this author Roberto Bertini Milan, Italy More articles by this author Luigi Filippo da Pozzo Bergamo, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...