MP50-12 THE USE OF RENAL NEPHROMETRY SCORES FOR PREDICTING TUMOR UPGRADING BETWEEN CORE BIOPSIES AND SURGICAL SPECIMENS: A PROSPECTIVE EX VIVO STUDY

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging III1 Apr 2015MP50-12 THE USE OF RENAL NEPHROMETRY SCORES FOR PREDICTING TUMOR UPGRADING BETWEEN CORE BIOPSIES AND SURGICAL SPECIMENS: A PROSPECTIVE EX VIVO STUDY Guiming Zhang, Yao Zhu, Hualei Gan, Hongkai Wang, Guohai Shi, Hailiang Zhang, Bo Dai, Chaofu Wang, and Dingwei Ye Guiming ZhangGuiming Zhang More articles by this author , Yao ZhuYao Zhu More articles by this author , Hualei GanHualei Gan More articles by this author , Hongkai WangHongkai Wang More articles by this author , Guohai ShiGuohai Shi More articles by this author , Hailiang ZhangHailiang Zhang More articles by this author , Bo DaiBo Dai More articles by this author , Chaofu WangChaofu Wang More articles by this author , and Dingwei YeDingwei Ye More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Purpose: Determination of Fuhrman grade (FG) on biopsies of renal masses is relatively inaccurate, being prone to underestimating the true grade as ascertained from surgical specimens. The current study evaluated whether anatomical features of tumors could predict tumor upgrading between core biopsies and surgical specimens. METHODS Materials and Methods: We prospectively enrolled 249 patients undergoing surgical resection of solid renal masses at our institution from 2012 to 2013. Tumor anatomical features were defined using RENAL nephrometry scores (RNS). Two peripheral and one central ex vivo core biopsies were taken from surgical specimens with an F18 gauge needle. Logistic regression was used to assess associations between covariates and FG upgrading. A comprehensive nomogram was constructed to quantitate the probability of tumor upgrading. RESULTS The median tumor size was 4.75 cm and FG upgrading occurred in 43.6% of cases. In low complex, intermediate complex and high complex tumors, the risk of FG upgrading was 22.0%, 47.6% and 50.6%, respectively. According to multivariate analyses, anatomical features R (radius) and L (location) scores correlated significantly with FG upgrading. A combination of anatomical features and core biopsy findings predicted tumor upgrading with an accuracy of 0.884. With a threshold of 30%, our nomogram identified 92.4% of cases with upgrading; however, it overrated 26.8% of patients without upgrading. CONCLUSIONS Conclusions: This ex vivo prospective study demonstrated that RNS can aid prediction of FG upgrading between core biopsies and surgical specimens. Our nomogram uses anatomical features to predict true FG from renal biopsies. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e615-e616 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Guiming Zhang More articles by this author Yao Zhu More articles by this author Hualei Gan More articles by this author Hongkai Wang More articles by this author Guohai Shi More articles by this author Hailiang Zhang More articles by this author Bo Dai More articles by this author Chaofu Wang More articles by this author Dingwei Ye More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...