The association between renal tumour scoring system components and complications of partial nephrectomy.
BACKGROUND
We evaluate the associations between 3 renal tumour scoring systems and their components with perioperative complications of partial nephrectomy.


METHODS
A consecutive cohort of partial nephrectomy patients was analyzed. Patient characteristics were abstracted from medical records. PADUA scores (preoperative aspects and dimensions used for anatomic classification), RENAL (radius exophyic/endophytic nearness anterior/posterior location scoring) nephrometry scores, and Centrality index (C-index) were determined from preoperative axial images by 2 independent reviewers. Cases were evaluated for postoperative complications up to 30 days after surgery. Pre-specified complication definitions were used for 33 potential medical and surgical complications. Unadjusted and adjusted associations between overall scores, individual components, and complications were determined using log binomial regression.


RESULTS
In total, 118 patients were included in the study. Of these, 36 (30.5%) surgical complications occurred in 27 (22.9%) patients. Fourteen (11.9%) were Clavien grade ≥3. Overall PADUA score was significantly associated with surgical and overall complications after adjusting for potential confounders. Among all components of the 3 scoring systems, only tumour diameter and exophytic/endophytic nature of the tumour were significantly associated with complications after adjusting for the other components of the respective scoring system (p < 0.05).


CONCLUSIONS
Renal tumour scoring systems may help predict the risk of complications after partial nephrectomy. Further refinement of current systems is required. A first step would be to include only components that are significantly associated with complications.
Department of Surgery, Division of Urology, Ottawa, ON;
Darren
D
Desantis
Department of Surgery, Division of Urology, Ottawa, ON;
Luke T
LT
Lavallée
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON.
Kelsey
K
Witiuk
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON.
Ranjeeta
R
Mallick
Department of Surgery, Division of Urology, Ottawa, ON;
Fadi
F
Kamal
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON.
Dean
D
Fergusson
Department of Surgery, Division of Urology, Ottawa, ON;
Christopher
C
Morash
Department of Surgery, Division of Urology, Ottawa, ON;
Ilias
I
Cagiannos
Department of Surgery, Division of Urology, Ottawa, ON;
Rodney H
RH
Breau