title: Comparison of diameter-axial-polar nephrometry and RENAL nephrometry score for treatment decision-making in patients with small renal mass.
abstract: BACKGROUND
  The aim of this study was to evaluate our institution's experience in performing laparoscopic radical nephrectomy (LRN) and partial nephrectomy (PN) in patients with small renal masses.
  
  
  METHODS
  142 patients with cT1aN0M0 lesions were identified. 68 of these subjects were treated with LRN and 74 were treated with laparoscopic PN (LPN). The clinicopathological characteristics of the two groups of patients, including diameter-axial-polar (DAP) nephrometry and RENAL nephrometry score (RENAL-NS), operative results, and outcomes, were retrospectively analyzed.
  
  
  RESULTS
  A multivariate logistic regression analysis for the selection of PN as the treatment showed that tumor size, DAP nephrometry, RENAL-NS and imperative condition were all independent factors. The area under the curve receiver operating characteristics (ROC-AUC) of DAP and RENAL-NS for performing LPN were 0.897 and 0.825, respectively.
  
  
  CONCLUSIONS
  Although LRN was performed in patients with a high nephrometry score in this study, open partial nephrectomy (OPN) should be considered for patients with a high nephrometry score in T1a renal cell carcinoma (RCC) because of better functional and similar oncological outcomes. Based on ROC analysis, when DAP is 6 or less, LPN should be considered and when DAP is 7 or more, OPN should be considered.
authors: The Department of Urology, Graduation School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan, ynaya@koto.kpu-m.ac.jp.
authors: Yoshio
authors: Y
authors: Naya
authors: Akihiro
authors: A
authors: Kawauchi
authors: Masakatu
authors: M
authors: Oishi
authors: Takashi
authors: T
authors: Ueda
authors: Atsuko
authors: A
authors: Fujihara
authors: Yasuyuki
authors: Y
authors: Naito
authors: Terukazu
authors: T
authors: Nakamura
authors: Fumiya
authors: F
authors: Hongo
authors: Kazumi
authors: K
authors: Kamoi
authors: Koji
authors: K
authors: Okihara
authors: Tsuneharu
authors: T
authors: Miki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012372:ROC Curve; D012044:Regression Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden