title: Preoperative Aspects and Dimensions Used for Anatomical Score Predicts Treatment Failures in Laparoscopic Cryoablation of Small Renal Masses.
abstract: To determine the potential of the preoperative aspects and dimensions used for anatomical (PADUA) classification score as a predictive tool in relation to residual unablated tumor and disease-free survival (DFS) following laparoscopy-assisted cryoablation (LCA) of small renal masses.
  
  
  
  A multi-institutional cohort of 212 patients with biopsy-verified T1N0M0 renal malignancies treated with LCA between August 2005 and September 2014 were retrospectively investigated with respect to oncologic outcomes.
  
  
  
  The preoperative PADUA score was found to be low (6-7 points) in 70 patients (33%), moderate (8-9 points) in 86 patients (40.6%), and high (10-14 points) in 56 patients (26.4%). The mean PADUA score was significantly higher in cases (n = 11) with residual unablated tumor (10.4 vs 8.1, p < 0.001) and in cases (n = 8) with local tumor recurrence (9.8 vs 8.1, p < 0.001) at a mean follow-up of 37 (95% confidence interval: 34-40) months. The estimated 2-, 3-, and 5-year DFS for patients with a moderate PADUA score was 96%, 94%, and 94% compared with 95%, 87%, and 81%, respectively, for patients with a high PADUA score (log-rank, p = 0.003). The PADUA score did not predict overall survival.
  
  
  
  The PADUA score significantly predicts residual unablated tumor and DFS following LCA. Further studies are needed to validate the efficacy of the PADUA score in relation to oncologic outcomes following ablative procedures.
authors.affiliation: 1 Department of Urology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Tommy Kjærgaard
authors.initials: TK
authors.lastname: Nielsen
authors.affiliation: 2 Department of Urology, Onze Lieve Vrouwe Gasthuis , Amsterdam, The Netherlands .
authors.forename: Brunolf W
authors.initials: BW
authors.lastname: Lagerveld
authors.affiliation: 1 Department of Urology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Øyvind
authors.initials: Ø
authors.lastname: Østraat
authors.affiliation: 3 Department of Radiology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Gratien
authors.initials: G
authors.lastname: Andersen
authors.affiliation: 4 Department of Pathology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Søren
authors.initials: S
authors.lastname: Høyer
authors.affiliation: 2 Department of Urology, Onze Lieve Vrouwe Gasthuis , Amsterdam, The Netherlands .
authors.forename: Johan
authors.initials: J
authors.lastname: van der Zee
authors.affiliation: 1 Department of Urology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Lasse
authors.initials: L
authors.lastname: Nonboe
authors.affiliation: 3 Department of Radiology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Ole
authors.initials: O
authors.lastname: Graumann
authors.affiliation: 1 Department of Urology, Aarhus University Hospital , Aarhus, Denmark .
authors.forename: Michael
authors.initials: M
authors.lastname: Borre
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018365:Neoplasm, Residual / Q000601:surgery; D009392:Nephrectomy / Q000379:methods*; D057234:Preoperative Period; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome