M C Kriegmair1, P Mandel2, A Moses3, C Bolenz3, M S Michel3, D Pfalzgraf3. 1. Department of Urology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. maximilian.kriegmair@medma.uni-heidelberg.de. 2. Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 3. Department of Urology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Abstract
PURPOSE: The aim of the study was to externally validate the Zonal NePhRO Score (ZNS) published in 2014 as latest and superior nephrometry score in terms of prediction of perioperative complications and outcome of open partial nephrectomies (OPNs). METHODS: We identified 200 consecutive patients who underwent OPN. Analysis of preoperative CT or MRI scans and retrospective analysis of the patients' clinical records were performed. Tumour complexity was stratified according to the ZNS into three categories: low (4-6), moderate (7-9) and high (10-12) complexity. Predictors for perioperative complications and surgical parameters were identified using univariate and multivariate logistic regression. RESULTS: Tumour complexity was graded in 19.8 % of the cases as low, in 50.3 % as moderate and in 29.9 % as high. In the multivariate analysis, ZNS was significantly associated with a higher complication rate (OR 1.25, 95 % CI 1.04-1.49, p = 0.014), longer ischaemia time (IT) (β = 1.19, 95 % CI 0.33-2.05, p = 0.007), postoperative drop of estimated glomerular filtration rate (eGFR) (β = -1.86, 95 % CI -3.71 to -0.01, p = 0.049) and opening of the collecting system (CS) (OR 1.72, 95 % CI 1.40-2.10, p < 0.001). In addition, age and body mass index were identified as independent predictors for complications (OR 1.03, 95 % CI 1.00-1.06, p = 0.043 and OR 1.08, 95 % CI 1.00-1.15, p = 0.031). CONCLUSION: The present study is the first external validation of the ZNS as a predictor of perioperative complications in patients undergoing OPN. A higher ZNS score was associated with a longer IT, a higher rate of opening the CS and drop of eGFR.
PURPOSE: The aim of the study was to externally validate the Zonal NePhRO Score (ZNS) published in 2014 as latest and superior nephrometry score in terms of prediction of perioperative complications and outcome of open partial nephrectomies (OPNs). METHODS: We identified 200 consecutive patients who underwent OPN. Analysis of preoperative CT or MRI scans and retrospective analysis of the patients' clinical records were performed. Tumour complexity was stratified according to the ZNS into three categories: low (4-6), moderate (7-9) and high (10-12) complexity. Predictors for perioperative complications and surgical parameters were identified using univariate and multivariate logistic regression. RESULTS: Tumour complexity was graded in 19.8 % of the cases as low, in 50.3 % as moderate and in 29.9 % as high. In the multivariate analysis, ZNS was significantly associated with a higher complication rate (OR 1.25, 95 % CI 1.04-1.49, p = 0.014), longer ischaemia time (IT) (β = 1.19, 95 % CI 0.33-2.05, p = 0.007), postoperative drop of estimated glomerular filtration rate (eGFR) (β = -1.86, 95 % CI -3.71 to -0.01, p = 0.049) and opening of the collecting system (CS) (OR 1.72, 95 % CI 1.40-2.10, p < 0.001). In addition, age and body mass index were identified as independent predictors for complications (OR 1.03, 95 % CI 1.00-1.06, p = 0.043 and OR 1.08, 95 % CI 1.00-1.15, p = 0.031). CONCLUSION: The present study is the first external validation of the ZNS as a predictor of perioperative complications in patients undergoing OPN. A higher ZNS score was associated with a longer IT, a higher rate of opening the CS and drop of eGFR.
Entities:
Keywords:
Complications; Open partial nephrectomy; Validation; Zonal NephRo Score
Authors: Matthew N Simmons; Shahab P Hillyer; Byron H Lee; Amr F Fergany; Jihad Kaouk; Steven C Campbell Journal: J Urol Date: 2012-06-13 Impact factor: 7.450
Authors: Hendrik Van Poppel; Luigi Da Pozzo; Walter Albrecht; Vsevolod Matveev; Aldo Bono; Andrzej Borkowski; Marc Colombel; Laurence Klotz; Eila Skinner; Thomas Keane; Sandrine Marreaud; Sandra Collette; Richard Sylvester Journal: Eur Urol Date: 2010-12-22 Impact factor: 20.096
Authors: Stavros I Tyritzis; Stefanos Papadoukakis; Ioannis Katafigiotis; Ioannis Adamakis; Ioannis Anastasiou; Konstantinos G Stravodimos; Christos Alamanis; Dionisios Mitropoulos; Constantinos A Constantinides Journal: BJU Int Date: 2011-10-07 Impact factor: 5.588
Authors: Harry Nisen; Petri Heimonen; Lauri Kenttä; Harri Visapää; Jessica Nisen; Kimmo Taari Journal: Scand J Urol Date: 2014-11-11 Impact factor: 1.612
Authors: Christopher J Kane; Katherine Mallin; Jamie Ritchey; Matthew R Cooperberg; Peter R Carroll Journal: Cancer Date: 2008-07-01 Impact factor: 6.860
Authors: Victor Dubeux; José Fernando Cardona Zanier; Carolina Gianella Cobo Chantong; Fabricio Carrerette; Pedro Nicolau Gabrich; Ronaldo Damião Journal: Radiol Bras Date: 2022 Jul-Aug