title: Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: a retrospective study of 245 patients undergoing laparoscopic partial nephrectomy.
abstract: OBJECTIVE
  To investigate the clinical significance of preoperative aspects and dimensions used for anatomic (PADUA) and radius exophytic/endophytic nearness anterior/posterior location (RENAL) scoring systems for renal neoplasms in patients undergoing laparoscopic partial nephrectomy.
  
  
  METHODS
  A retrospective analysis was carried out on clinical data of 245 Chinese patients with renal neoplasms undergoing laparoscopic partial nephrectomy from June 2008 to June 2012. The perioperative complications and variables, as well as PADUA and RENAL score, were compared.
  
  
  RESULTS
  The PADUA and RENAL scoring systems were significantly associated with percent change in estimated glomerular filtration rate (P = 0.032 and P = 0.026 respectively), whereas the RENAL scoring system was also significantly associated with warm ischemia time (P = 0.032). On multivariate analysis, both scores were able to predict percent change in estimated glomerular filtration rate (PADUA, P = 0.011; RENAL, P = 0.028). There were no significant associations between the two scoring systems assessed and the occurrence of complications or tumor stage. The correlation between PADUA classification and RENAL nephrometry score was significant (P < 0.0001). Fleiss' generalized kappa was 0.69-0.89 for the various components of the PADUA score and 0.67-0.89 for the RENAL nephrometry components.
  
  
  CONCLUSIONS
  The PADUA classification and RENAL nephrometry score are comprehensive assessment tools for delineating renal tumor anatomy. The reproducibility of the PADUA and RENAL scores is substantial, but further research is required to evaluate its performance in more accurately predicting operative and patient-related outcomes.
authors.affiliation: Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center.
authors.forename: Zhong-Yuan
authors.initials: ZY
authors.lastname: Zhang
authors.forename: Qi
authors.initials: Q
authors.lastname: Tang
authors.forename: Xue-Song
authors.initials: XS
authors.lastname: Li
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.forename: Wesley A
authors.initials: WA
authors.lastname: Mayer
authors.forename: Jing-Yun
authors.initials: JY
authors.lastname: Wu
authors.forename: Xue-Dong
authors.initials: XD
authors.lastname: Yang
authors.forename: Xiao-Chun
authors.initials: XC
authors.lastname: Zhang
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Wang
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Zhou
mesh_terms: D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies
keywords: classification; laparoscopic; nephrectomy; renal tumor; warm ischemia time