title: Prediction of postoperative renal function by preoperative serum creatinine level and three-dimensional diagnostic image reconstruction in patients with renal cell carcinoma.
abstract: OBJECTIVE
  To investigate retrospectively whether postoperative renal function in patients with renal cell carcinoma can be preoperatively predicted by a combination of the preoperative serum creatinine (sCr) and the renal parenchymal volume (RPV) estimated by three-dimensional image reconstruction of the preoperative diagnostic imaging.
  
  
  METHODS
  Of 155 patients who had undergone radical nephrectomy, 76 were eligible for inclusion in our study (group 1). Group 2 was comprised of 26 of 37 patients who had undergone partial nephrectomy. The postoperative RPV in both groups was estimated from the preoperative computed tomography scans or magnetic resonance imaging and were compared with the actual RPV estimated from the postoperative imaging using a three-dimensional image reconstruction program. The postoperative creatinine clearance (Ccr) was predicted from the preoperative Ccr calculated from the sCr level and by the ratio of the postoperative/preoperative RPV. The correlations between the predicted postoperative Ccr and the actual, measured postoperative Ccr were analyzed statistically.
  
  
  RESULTS
  In both groups, a statistically significant correlation was found between the postoperative RPV, estimated from the preoperative images and postoperative images. The predicted postoperative Ccr correlated significantly with the actual, measured postoperative Ccr in group 1 (r = 0.86, P <0.0001) and group 2 (r = 0.98, P <0.0001). The postoperatively increased sCr achieved stable levels within 2 to 4 weeks after nephrectomy and showed no statistically significant subsequent changes during 3 years of follow-up.
  
  
  CONCLUSIONS
  The present results demonstrated that prediction of the postoperative Ccr, using the preoperative sCr and the postoperative RPV estimated from the preoperative routine diagnostic imaging, is a simple and reliable method for the evaluation of early and medium-term postoperative renal function.
authors.affiliation: Department of Urology, Nara Medical University, Nara, Japan.
authors.forename: Nobumichi
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Tani
authors.forename: Masahito
authors.initials: M
authors.lastname: Yoshii
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hirao
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Ozono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000473:pathology / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000473:pathology* / Q000503:physiopathology; D007680:Kidney Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009929:Organ Size; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003404:Creatinine