The Comparison of Three Renal Tumor Scoring Systems: C-Index, PADUA, and RENAL Nephrometry Scores
The Comparison of Three Renal Tumor Scoring Systems: C-Index, PADUA, and RENAL Nephrometry Scores
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DOI：
10.1089/end.2011.0301
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发表时间：
2011-12-01
影响因子：
2.7
通讯作者：
Kavoussi, Louis R.
中科院分区：
文献类型：
--
作者：
Okhunov, Zhamshid;Rais-Bahrami, Soroush;Kavoussi, Louis R.
背景和目的：中心指数（C指数），术前方面和尺寸用于解剖（P.A.D.U.A.）分类和半径。外生/内生的接近。前后位置（R. E. N. A.L.）肾测量方案被开发为标准化评分系统（SS）以量化肾肿瘤的解剖学特征。本研究的目的是建立可靠性和评估这三个SS和围手术期和术后variable.Patients和方法之间的关系：回顾性图表审查进行了101例谁接受腹腔镜肾部分切除术。使用斯皮尔曼相关性将肾功能测定方案与术中和术后参数相关联。此外，通过比较两名住院医师和一名回顾这些患者术前CT研究的研究员分配的评分，对50名患者进行了观察者间可靠性评估。结果：观察者间相关性为C指数0.84，P.A.D.U.A.为0.81，R. E. N. A.L.评分系统为0.92，显示了良好的观察者间可靠性。所有三种SS均与热缺血时间（WIT）显著相关（C指数，P = -0.44; P.A.D.U.A.，P = 0.25; P = 0.32）和肌酐水平的百分比变化（C指数，P = -0.33; P.A.D.U.A.，P = 0.37; P = 0.37）。评估的三个SS中的任何一个与并发症的发生、手术时间或估计失血量之间均无显著相关性。P.A.D.U.A. R. E. N. A.L. SS和住院时间;然而，C-Index确实显示出较低评分的患者住院时间较长的显著相关性（P =-0.21.Conclusions：所有三种评分系统在观察者中均表现出可靠性，并代表了定量描述肾肿瘤的新方法。它们都与WIT、肌酐水平的百分比变化和肿瘤大小相关。然而，它们与研究的任何其他围手术期参数无关。此时，这些SS提供了描述肾肿瘤的通用语言。
Background and Purpose: The centrality-index (C-Index), preoperative aspects and dimensions used for anatomic (P.A.D.U.A.) classification, and radius. exophyic/endophytic. nearness. anterior/posterior. location (R.E.N.A.L.) nephrometry schemes were developed as standardized scoring systems (SS) to quantify anatomic characteristics of kidney tumors. The objective of this study was to establish reliability and assess relationships between these three SS and perioperative and postoperative variables.Patients and Methods: A retrospective chart review was performed in 101 patients who underwent laparoscopic partial nephrectomy. The nephrometry schemes were correlated with intraoperative and postoperative parameters using Spearman correlations. In addition, interobserver reliability was assessed on 50 of the patients by interclass correlations comparing the scores assigned by two residents and one fellow who reviewed preoperative CT studies of these patients.Results: The interobserver correlation was 0.84 for the C-Index, 0.81 for the P.A.D.U.A., and 0.92 for the R.E.N.A.L. scoring systems, demonstrating excellent interobserver reliability. All three SS were significantly associated with warm ischemia time (WIT) (C-Index, P = -0.44; P.A.D.U.A., P = 0.25; R.E.N.A.L., P = 0.32) and percent change in creatinine level (C-Index, P = -0.33; P.A.D.U.A., P = 0.37; R.E.N.A.L., P = 0.37). There were no significant associations between any of the three SS assessed and the occurrence of complications, operative time, or estimated blood loss. No significant correlation was found between the P.A.D.U.A. and R.E.N.A.L. SS and length of stay; however, C-Index did show a significant relationship for patients with lower scores having longer hospital stays (P = -0.21).Conclusions: All three scoring systems demonstrated reliability among observers and represent novel methods of quantitatively describing renal tumors. They were all associated with WIT, percent change in creatinine level, and tumor size. They did not, however, correlate with any other perioperative parameters investigated. At this time, these SS provide a common language for describing renal tumors.