Zonal NePhRO Scoring System: A Superior Renal Tumor Complexity Classification Model
Zonal NePhRO Scoring System: A Superior Renal Tumor Complexity Classification Model
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DOI：
10.1016/j.clgc.2013.07.009
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发表时间：
2014-02-01
影响因子：
3.2
通讯作者：
Spiess, Philippe E.
中科院分区：
文献类型：
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作者：
Hakky, Tariq S.;Baumgarten, Adam S.;Spiess, Philippe E.
许多肾肿瘤复杂性评分系统可能很复杂，并且难以准确测量终点。这里我们介绍一下分区 NePhRO 评分系统。这项回顾性研究表明，分区 NePhRO 评分系统比 RENAL 肾测量评分系统更准确地预测围手术期并发症发生率。 背景：自从第一个标准化肾肿瘤复杂性系统出现以来，许多后续评分系统被引入，其中许多系统都很复杂，可能导致难以准确测量数据终点。鉴于这些限制，我们引入了新的区域 NePhRO 评分系统。患者和方法：带状 NePhRO 评分基于 4 个解剖部分，评分为 1、2 或 3，它们的总和用于对肾肿瘤进行分类。带状 NePhRO 评分系统由收集系统的 (Ne)arness、肾脏中肿瘤的 (Ph) 物理位置、肿瘤的 (R) 直径和肿瘤的 (O) 组织组成。在这项回顾性研究中，我们评估了临床分期 T1a 或 T1b 的患者，这些患者接受了由 2 名泌尿生殖外科医生进行的开放性肾部分切除术。每个肾单位都被分配了带状 NePhRO 评分和 RENAL（半径、外生/内生特性、肿瘤与集合系统或窦的距离（以毫米为单位）、前/后、相对于极线的位置）评分，并且盲法审查者使用相同的术前影像学研究来获得这两个评分。收集的其他数据点包括年龄、钳夹时间、并发症发生率、漏尿率、术中失血量和病理肿瘤大小。结果：166 名患者接受了开放性肾部分切除术。使用经过验证的 Clavien-Dindo 系统对 37 种围手术期并发症进行了定量；它们的发生是通过单变量和多变量分析的 NePhRO 评分来预测的 (P=.0008)。仅在单变量分析中，临床分期、术中失血量和肿瘤直径均与带状 NePhRO 评分相关。结论：带状 NePhRO 评分系统是一种更简单的工具，可以准确预测肾脏病变的手术复杂性。 (C) 2014 Elsevier Inc. 保留所有权利。
Many renal tumor complexity scoring systems can be complicated and make it difficult to accurately measure end points. Here we introduce the zonal NePhRO scoring system. This retrospective study demonstrates that the zonal NePhRO scoring system predicts perioperative complication rates more accurately than does the RENAL nephrometry scoring system.Background: Since the advent of the first standardized renal tumor complexity system, many subsequent scoring systems have been introduced, many of which are complicated and can make it difficult to accurately measure data end points. In light of these limitations, we introduce the new zonal NePhRO scoring system. Patients and Methods: The zonal NePhRO score is based on 4 anatomical components that are assigned a score of 1, 2, or 3, and their sum is used to classify renal tumors. The zonal NePhRO scoring system is made up of the (Ne)arness to collecting system, (Ph)ysical location of the tumor in the kidney, (R)adius of the tumor, and (O)rganization of the tumor. In this retrospective study, we evaluated patients exhibiting clinical stage T1a or T1b who underwent open partial nephrectomy performed by 2 genitourinary surgeons. Each renal unit was assigned both a zonal NePhRO score and a RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) score, and a blinded reviewer used the same preoperative imaging study to obtain both scores. Additional data points gathered included age, clamp time, complication rate, urine leak rate, intraoperative blood loss, and pathologic tumor size. Results: One hundred sixty-six patients underwent open partial nephrectomy. There were 37 perioperative complications quantitated using the validated Clavien-Dindo system; their occurrence was predicted by the NePhRO score on both univariate and multivariate analyses (P=.0008). Clinical stage, intraoperative blood loss, and tumor diameter were all correlated with the zonal NePhRO score on univariate analysis only. Conclusion: The zonal NePhRO scoring system is a simpler tool that accurately predicts the surgical complexity of a renal lesion. (C) 2014 Elsevier Inc. All rights reserved.