You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV1 Apr 2017MP59-05 CRITICAL ANALYSIS AND ASSESSMENT OF CLINICAL UTILITY OF NEPHROMETRY SCORES FOR THE PREDICTION OF COMPLICATIONS AFTER NEPHRON SPARING SURGERY Alessandro Larcher, Fabio Muttin, Nicola Fossati, Paolo Dell'Oglio, Francesco Ripa, Francesco Trevisani, Alexandre Mottrie, Zachary Hamilton, Ithaar Derweesh, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Roberto Bertini, and Umberto Capitanio Alessandro LarcherAlessandro Larcher More articles by this author , Fabio MuttinFabio Muttin More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Francesco RipaFrancesco Ripa More articles by this author , Francesco TrevisaniFrancesco Trevisani More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Zachary HamiltonZachary Hamilton More articles by this author , Ithaar DerweeshIthaar Derweesh More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Roberto BertiniRoberto Bertini More articles by this author , and Umberto CapitanioUmberto Capitanio More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1821AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite the association between nephrometry scores and the risk of complications following nephron sparing surgery [NSS] is established, data regarding predictive accuracy [PA] and clinical net-benefit [NB] of nephrometry scores-based prognostication are scarce. The aim of the study was to perform a head-to-head comparison of PADUA score-, RENAL score- and clinical tumour size-based prognostication of complications following NSS. METHODS 214 patients diagnosed with a cT1-2 cN0 cM0 renal mass elected for NSS and collected into a prospective database were assessed. The outcomes of the study were overall and Clavien-Dindo [CD] grade ≥2 complication rates. Logistic regression analyses predicting overall and CD grade ≥2 complications were fitted. PA was estimated with C index. NB was evaluated with decision curve analysis. RESULTS The overall complications rate was 36%. The CD grade ≥2 complications rate was 20%. The most common specific complication was anemia/haematoma. At logistic regression analysis, PADUA score resulted associated with higher risk of overall complications rate (Odds ratio [OR] 1.24; 95% Confidence intervals [CI] 1.03-1.50; p=0.03). Conversely, RENAL score (OR 1.16; CI 0.95-1.41; p=0.1) and clinical tumour size were not associated with the risk of overall complications (OR 1.21; CI 0.99-1.47; p=0.058). Moreover, PADUA score, RENAL score and clinical tumour size were not associated with the risk of CD grade ≥2 complications (p>0.05). Harrel′s C index resulted 0.59 for PADUA score-, 0.57 for RENAL score- and 0.59 for clinical tumour size-based prediction. At decision curve analysis, the recorded NB was consistently low regardless of the prediction strategy (Figure 1). CONCLUSIONS PADUA and RENAL score were not associated with the risk of clinically relevant complications after NSS. Moreover, their ability to predict complications is diagnostically inadequate. Neither PADUA nor RENAL score were superior to the use of clinical tumour size only with respect to PA or NB. These findings suggest that, despite PADUA and RENAL scores represent accurate classification systems for the anatomic complexity of renal tumours, none of them is an optimal predictor of clinical outcomes. © 2017FiguresReferencesRelatedDetailsCited byLaguna M (2019) Re: Postoperative Complications Increase the Risk of Long-Term Chronic Kidney Disease after Nephron-Sparing Surgery in Patients with Renal Cancer and Normal Preoperative Renal FunctionJournal of Urology, VOL. 203, NO. 2, (248-249), Online publication date: 1-Feb-2020. Volume 197Issue 4SApril 2017Page: e782 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Alessandro Larcher More articles by this author Fabio Muttin More articles by this author Nicola Fossati More articles by this author Paolo Dell'Oglio More articles by this author Francesco Ripa More articles by this author Francesco Trevisani More articles by this author Alexandre Mottrie More articles by this author Zachary Hamilton More articles by this author Ithaar Derweesh More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Roberto Bertini More articles by this author Umberto Capitanio More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...