title: R.E.N.A.L. nephrometry score predicts postoperative recurrence of localized renal cell carcinoma treated by radical nephrectomy.
abstract: BACKGROUND
  We investigated the association between the R.E.N.A.L. nephrometry score (RNS) and the postoperative recurrence of localized renal cell carcinoma (RCC).
  
  
  METHODS
  We retrospectively analyzed a database comprising 91 patients with non-small localized RCC (pT1b-T2b) treated by radical nephrectomy at our hospital from January 2002 to March 2010. RNS was scored based on imaging findings at diagnosis. The Cox proportional hazards model was used to predict recurrence-free survival (RFS) and to calculate hazard ratio (HR).
  
  
  RESULTS
  The median age at operation was 63 years (range, 30-85 years). Postoperative recurrence occurred in 19 patients (21 %). Median RNS sum was 9 (range, 5-11). High RNS sum (10-12) was significantly associated with RFS (P = 0.0012). Multivariate analysis revealed that high RNS sum [HR, 9.05; 95 % confidence interval (CI), 2.11-63.9; P = 0.0019] were significantly associated with RFS. Regarding each component of RNS, only the L component, which referred to tumor location relative to the polar line, was associated with RFS (HR, 15.0; 95 % CI, 2.68-396; P = 0.0006).
  
  
  CONCLUSIONS
  RNS was associated with RFS in cases of non-small localized RCC (pT1b-2b), thus supporting its utility as a prognostic factor.
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Nagahara
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan. uemura@uro.med.osaka-u.ac.jp.
authors.forename: Motohide
authors.initials: M
authors.lastname: Uemura
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Atsunari
authors.initials: A
authors.lastname: Kawashima
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ujike
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyagawa
authors.affiliation: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies
keywords: Imaging; Nephrometry score; Radical nephrectomy; Recurrence; Renal cell carcinoma