title: Usefulness of R.E.N.A.L Nephrometry Scoring System and Centrality Index Score for Predicting Outcome of Laparoscopic Partial Nephrectomy.
abstract: OBJECTIVE
  The aim of this study was to investigate the clinical usefulness for prediction of outcome of laparoscopic partial nephrectomy (LPN) using the R.E.N.A.L nephrometry scoring system (RNS) and centrality index score (C-index).
  
  
  METHODS
  We retrospectively reviewed 64 patients who underwent LPN from 2010 to 2014 in our institution. The RNS and C-index scores were assigned according to the described protocols for their systems. The relationships between the patients' scores before surgery and the outcomes of LPN, warm ischemia time (WIT), operative time (ORT), estimated blood loss (EBL), and percent change in estimated glomerular filtration rate (eGFR) were analyzed retrospectively.
  
  
  RESULTS
  Mean tumor size was 3.1 cm, mean WIT was 27.6 minutes, mean ORT was 189.0 minutes, and mean EBL was 187 mL. Although the RNS had statistically significant correlations with WIT, ORT, and percent change in eGFR, these correlations were not score-dependent. For WIT, a statistically significant difference was observed between the low-risk group and the middle-risk group. For percent change in eGFR, a statistically significant difference was observed between the low-risk group and the high-risk group only. For the C-index, statistically significant correlations between complexity categories and WIT, ORT, EBL, and percent change in eGFR were observed. Regarding the raw C-index scores, linear correlations were observed between the scores and each outcome of LPN.
  
  
  CONCLUSIONS
  The RNS and C-index are useful for predicting the complexity of LPN. The C-index may be more suitable than the RNS for predicting postoperative renal function.
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sugiura
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Takahito
authors.initials: T
authors.lastname: Suyama
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Manato
authors.initials: M
authors.lastname: Kanesaka
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Ayumi
authors.initials: A
authors.lastname: Fujimoto
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Kyokushin
authors.initials: K
authors.lastname: Hou
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Araki
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuda
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Satoko
authors.initials: S
authors.lastname: Kojima
authors.affiliation: Department of Urology, Teikyo University Chiba Medical Center , Ichihara, Japan .
authors.forename: Yukio
authors.initials: Y
authors.lastname: Naya
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D052096:Warm Ischemia
keywords: R.E.N.A.L nephrometry scoring system; centrality index score; laparoscopic partial nephrectomy; predicting outcome