PURPOSE: Ficarra et al. (Eur Urol 56:786-793, 2009) published a preoperative anatomical classification (PADUA) to assess the impact of anatomical parameters of renal tumors on complication rate of nephron-sparing surgery (NSS). The objective of this study is to provide a bi-center external validation of this classification using the technique of hilar arterial clamping during open and laparoscopic NSS and to correlate the PADUA score to the ischemia time. METHODS: 240 consecutive tumors treated with open and laparoscopic NSS were reclassified according to the PADUA classification. Complications were graded according to the modified Clavien system (Dindo et al. in Ann Surg 240:205-213, 2004). Chi-square tests and multivariate logistic regression models addressed the predictive value of PADUA classification on overall complication rate and grade. RESULTS: Mean patient age was 62.2 +/- 13.3 years. Eastern Cooperative Oncology Group performance was 0 in 76%, 1 in 22% and 2 in 2%. 61 (25%) were treated laparoscopically. The median PADUA score was 7.5 (range 6-13). Mean surgery and ischemia time was 189 +/- 95 and 24 +/- 22 min, respectively. Overall complication rate was 23% (n = 54). On univariate analysis, the PADUA score correlated with complication rate (p < 0.001) of open and laparoscopic NSS. On multivariate, only the PADUA score correlated with complication rate (p = 0.0056). Ischemic time correlated with the PADUA score and was significantly higher in PADUA score > or = 10 (p = 0.034). CONCLUSIONS: The PADUA score is a reliable tool to preoperatively predict the risk of complications. In addition, it might be beneficial for a more objective patient selection for laparoscopic surgery and teaching NSS.
PURPOSE: Ficarra et al. (Eur Urol 56:786-793, 2009) published a preoperative anatomical classification (PADUA) to assess the impact of anatomical parameters of renal tumors on complication rate of nephron-sparing surgery (NSS). The objective of this study is to provide a bi-center external validation of this classification using the technique of hilar arterial clamping during open and laparoscopic NSS and to correlate the PADUA score to the ischemia time. METHODS: 240 consecutive tumors treated with open and laparoscopic NSS were reclassified according to the PADUA classification. Complications were graded according to the modified Clavien system (Dindo et al. in Ann Surg 240:205-213, 2004). Chi-square tests and multivariate logistic regression models addressed the predictive value of PADUA classification on overall complication rate and grade. RESULTS: Mean patient age was 62.2 +/- 13.3 years. Eastern Cooperative Oncology Group performance was 0 in 76%, 1 in 22% and 2 in 2%. 61 (25%) were treated laparoscopically. The median PADUA score was 7.5 (range 6-13). Mean surgery and ischemia time was 189 +/- 95 and 24 +/- 22 min, respectively. Overall complication rate was 23% (n = 54). On univariate analysis, the PADUA score correlated with complication rate (p < 0.001) of open and laparoscopic NSS. On multivariate, only the PADUA score correlated with complication rate (p = 0.0056). Ischemic time correlated with the PADUA score and was significantly higher in PADUA score > or = 10 (p = 0.034). CONCLUSIONS: The PADUA score is a reliable tool to preoperatively predict the risk of complications. In addition, it might be beneficial for a more objective patient selection for laparoscopic surgery and teaching NSS.
Authors: Ramakrishna Venkatesh; Kyle Weld; Caroline D Ames; Sherbourne R Figenshau; Chandru P Sundaram; Gerald L Andriole; Ralph V Clayman; Jaime Landman Journal: Urology Date: 2006-06 Impact factor: 2.649
Authors: Karim Touijer; Didier Jacqmin; Louis R Kavoussi; Francesco Montorsi; Jean Jacques Patard; Craig G Rogers; Paul Russo; Robert G Uzzo; Hendrik Van Poppel Journal: Eur Urol Date: 2009-10-20 Impact factor: 20.096
Authors: Alexander Mottrie; Peter Schatteman; Peter De Wil; Bart De Troyer; Giacomo Novara; Vincenzo Ficarra Journal: World J Urol Date: 2011-02-01 Impact factor: 4.226
Authors: Jay Simhan; Marc C Smaldone; Kevin J Tsai; Daniel J Canter; Tianyu Li; Alexander Kutikov; Rosalia Viterbo; David Y T Chen; Richard E Greenberg; Robert G Uzzo Journal: Eur Urol Date: 2011-05-25 Impact factor: 20.096
Authors: Luke T Lavallée; Darren Desantis; Fadi Kamal; Brian Blew; James Watterson; Ranjeeta Mallick; Dean Fergusson; Christopher Morash; Ilias Cagiannos; Rodney H Breau Journal: Can Urol Assoc J Date: 2013-04-16 Impact factor: 1.862
Authors: Tobias Klatte; Vincenzo Ficarra; Christian Gratzke; Jihad Kaouk; Alexander Kutikov; Veronica Macchi; Alexandre Mottrie; Francesco Porpiglia; James Porter; Craig G Rogers; Paul Russo; R Houston Thompson; Robert G Uzzo; Christopher G Wood; Inderbir S Gill Journal: Eur Urol Date: 2015-04-22 Impact factor: 20.096
Authors: Michael Aertsen; Frederik De Keyzer; Hendrik Van Poppel; Steven Joniau; Liesbeth De Wever; Evelyne Lerut; Raymond Oyen; Filip Claus Journal: Eur Radiol Date: 2012-07-16 Impact factor: 5.315