title: The association between the anatomical features of renal tumours and the functional outcomes of robot-assisted partial nephrectomy.
abstract: BACKGROUND
  We evaluated the the association between PADUA scores and postoperative renal function (after robot-assisted partial nephrectomy [RAPN]) and between PADUA scores and warm ischemic time (during RAPN).
  
  
  METHODS
  We reviewed the clinical records of 106 patients who underwent RAPN for a single localized renal tumour between April 2009 and June 2012. Postoperative renal function was evaluated using estimated glomerular filtration rate (eGFR) in 85 patients who were followed for at least 6 months. PADUA scores for renal tumours were calculated using contrast-enhanced computed tomography images, if needed, along with magnetic resonance images in some cases.
  
  
  RESULTS
  A PADUA score ≥10 and WIT ≥30 minutes were observed in 18 (17.0%) and 51 (48.1%) cases, respectively. PADUA scores were significantly correlated with WIT (p = 0.019) and percent change in eGFR at 6 months postoperatively (p = 0.005). PADUA score (continuous variable, odds ratio [OR] 1.694, p = 0.007) and the high-risk group (PADUA score ≥10) (OR 5.429; p = 0.020) were significantly associated with a WIT of ≥30 minutes by multivariate analysis. A 1-point increase in the PADUA score was associated with an eGFR decrease of >20% at 6 months after RAPN (OR 1.799; p = 0.076). In addition, a PADUA score ≥10, or high risk, (OR 13.965; p = 0.003) was an independent predictor of an eGFR decrease of >20% at 6 months after RAPN.
  
  
  CONCLUSIONS
  The PADUA classification can reliably predict WIT and postoperative renal functional outcome after RAPN. Furthermore, the study suggests that anatomical aspects of renal tumours are associated with functional outcome after RAPN.
authors.affiliation: Department of Urology, Sanggye Paik Hospital, Inje University College of Medicine, Dongil-ro, Nowon-gu, Seoul, Republic of Korea;
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Dongjak-gu, Seoul, Republic of Korea;
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
authors.forename: Chanhoo
authors.initials: C
authors.lastname: Jeon
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
authors.forename: Kyungtae
authors.initials: K
authors.lastname: Ko
authors.affiliation: Department of Urology, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul, Republic of Korea.
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim