Significance of the R.E.N. A.L. nephrometry scoring system in renal tumour of T1 stage

Abstract

To evaluate the application value of R.E.N. A.L. nephrometry score for surgery type decisions of T1 stage renal tumor. Clinical data including image data, surgery type and prognosis etc were collected retrospectively for 122 cases from January 2010 to December 2012. There were 76 male and 46 female patients and they were 29-82 years (mean 51 years). The body mass index was (22.8 ± 3.9) kg/m(2). The patients were undergoing surgical excision with renal tumor of T1 stage. The R.E.N. A.L. nephrometry score was analyzed to evaluate their relationships to surgery type (RN or NSS) and the approach of NSS (ONSS or LNSS) using chi-square tests, Fisher's exact tests, and logistic regressions analysis. All surgery had been completed. The surgery included RN of 45 patients, LNSS of 45 patients and ONSS of 32 patients. The R.E.N. A.L. nephrometry score was significantly associated with the type of surgery (χ(2) = 27.89, P < 0.05), and the NSS approach (χ(2) = 12.87, P < 0.05). When the scores less than 7 points, it is majorly treated by nephron sparing surgery (92.9%), and when the scores more than 9 points, it is majorly treated by radical nephrectomy (69.4%). Individual component scores were analyzed to evaluate that they were all related to surgery type (χ(2) = 7.00-14.57, P < 0.05), and the individual component N associated the surgery type mostly. Furthermore, individual component R,E,N and L were statistically significant predictors of the NSS approach (χ(2) = 4.92-15.07, P < 0.05). The R.E.N. A.L. nephrometry scoring system provides a simple, useful, and stable system to character the salient renal anatomy of T1 stage, and can provide the best surgery approach.