Alessandro Tafuri1,2,3, Marco Sandri4, Alberto Martini5, Umberto Capitanio6, Guglielmo Mantica7, Carlo Terrone7, Maria Furlan8, Claudio Simeone8, Daniele Amparore9, Francesco Porpiglia9, Andrea Minervini10, Andrea Mari10, Maria Angela Cerruto1, Alessandro Antonelli11. 1. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Aristide Stefani 1, 37126, Verona, Italy. 2. Department of Urology, "Vito Fazzi" Hospital, Lecce, Italy. 3. Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy. 4. Big & Open Data Innovation Laboratory (BODaI-Lab), University of Brescia, Brescia, Italy. 5. Department of Urology and Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 6. Unit of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy. 7. Department of Urology, Policlinico San Martino Hospital, University of Genoa, Genova, Italy. 8. Department of Urology, Spedali Civili of Brescia, Brescia, Italy. 9. Division of Urology, Department of Oncology, School of Medicine, University of Turin, San Luigi Hospital, Orbassano (Turin), Italy. 10. Department of Urology, University of Florence, Careggi Hospital, San Luca Nuovo, Florence, Italy. 11. Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Aristide Stefani 1, 37126, Verona, Italy. alessandro.antonelli@univr.it.
Abstract
PURPOSE: To externally validate the Palacios' equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC). MATERIALS AND METHODS: Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients' data were used to calculate the predicted NB-GFR through the Palacios' equation: predicted NB-GFR = 35.03 + 0.65 ∙ preoperative GFR - 18.19 ∙ (if radical nephrectomy) - 0.25 ∙ age + 2.83 ∙ (if tumor size > 7 cm) - 2.09 ∙ (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3-12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. RESULTS: 2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m2 (IQR 56.1-90.1) and 64.2 ml/min/1.73 m2 (IQR 49.6-83); the median predicted NB-GFR was 71.1 ml/min/1.73 m2 (IQR 58-81.5) and 62.6 ml/min/1.73m2 (IQR 47.9-75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m2 in the cohort#1 and #2, respectively. The Palacio's equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m2 and 35 ml/min/1.73m2 in cohort#1 and #2. The Lin's concordance correlation coefficient was 0.79 (95% CI 0.77-0.81) and 0.83 (95% CI 0.82-0.85). CONCLUSIONS: We confirm the predictive performances of Palacios' equation, supporting its utilization in clinical practice.
PURPOSE: To externally validate the Palacios' equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC). MATERIALS AND METHODS: Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients' data were used to calculate the predicted NB-GFR through the Palacios' equation: predicted NB-GFR = 35.03 + 0.65 ∙ preoperative GFR - 18.19 ∙ (if radical nephrectomy) - 0.25 ∙ age + 2.83 ∙ (if tumor size > 7 cm) - 2.09 ∙ (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3-12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. RESULTS: 2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m2 (IQR 56.1-90.1) and 64.2 ml/min/1.73 m2 (IQR 49.6-83); the median predicted NB-GFR was 71.1 ml/min/1.73 m2 (IQR 58-81.5) and 62.6 ml/min/1.73m2 (IQR 47.9-75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m2 in the cohort#1 and #2, respectively. The Palacio's equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m2 and 35 ml/min/1.73m2 in cohort#1 and #2. The Lin's concordance correlation coefficient was 0.79 (95% CI 0.77-0.81) and 0.83 (95% CI 0.82-0.85). CONCLUSIONS: We confirm the predictive performances of Palacios' equation, supporting its utilization in clinical practice.
Authors: Periklis Koukourikis; Ali Abdullah Alqahtani; Ahmad Almujalhem; Jongsoo Lee; Woong Kyu Han; Koon Ho Rha Journal: Int J Urol Date: 2021-02-18 Impact factor: 3.369
Authors: Giuseppe Fallara; Alessandro Larcher; Giuseppe Rosiello; Daniele Raggi; Laura Marandino; Alberto Martini; Giuseppe Basile; Gianmarco Colandrea; Daniele Cignoli; Federico Belladelli; Chiara Re; Giacomo Musso; Francesco Cei; Roberto Bertini; Alberto Briganti; Andrea Salonia; Francesco Montorsi; Andrea Necchi; Umberto Capitanio Journal: World J Urol Date: 2022-09-20 Impact factor: 3.661