The Comparison of R.E.N.A.L., PADUA and Centrality Index Score in Predicting Perioperative Outcomes and Complications after Laparoscopic Radio Frequency Ablation of Renal Tumors

Xiaofeng Chang; Tieshi Liu; Fan Zhang; Cheng Qian; Changwei Ji; Xiaozhi Zhao; Guangxiang Liu; Hongqian Guo

doi:10.1016/j.juro.2015.03.095

The Comparison of R.E.N.A.L., PADUA and Centrality Index Score in Predicting Perioperative Outcomes and Complications after Laparoscopic Radio Frequency Ablation of Renal Tumors

J Urol. 2015 Oct;194(4):897-902. doi: 10.1016/j.juro.2015.03.095. Epub 2015 Mar 23.

Authors

Xiaofeng Chang¹, Tieshi Liu², Fan Zhang², Cheng Qian³, Changwei Ji², Xiaozhi Zhao², Guangxiang Liu², Hongqian Guo⁴

Affiliations

¹ Department of Urology, the Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China; Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
² Department of Urology, the Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
³ Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
⁴ Department of Urology, the Affiliated Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: dr.guohq@gmail.com.

PMID: 25813450
DOI: 10.1016/j.juro.2015.03.095

Abstract

Purpose: We assessed the association between the R.E.N.A.L., PADUA and centrality index scores and perioperative outcomes, and determined the efficacy of each scoring system over the simple parameter of tumor size.

Materials and methods: We conducted a retrospective review of the records of patients who underwent laparoscopic radio frequency ablation of renal tumors from February 2006 to April 2014 at our institution. Tumors were categorized using the R.E.N.A.L., PADUA and centrality index score, which were determined by analyzing preoperative imaging. The relationships between each variable and change in glomerular filtration rate, estimated blood loss, operative time and postoperative complications were examined.

Results: Laparoscopic radio frequency ablation was performed in 215 selected patients with preoperative imaging available. The interclass correlations coefficient of the 3 observers was 0.87, 0.84 and 0.82 for the C-Index, the R.E.N.A.L. and the PADUA scoring system, respectively. R.E.N.A.L. score, PADUA score and PADUA complexity were significantly associated with postoperative complications (p=0.040, 0.015 and 0.006, respectively). However, major complications were only associated with high PADUA complexity (chi-square 23.851, p <0.05). Each scoring system had a significant association with operative time and estimated blood loss (p <0.05), except that the C-index score had no relationship with estimated blood loss (p=0.083). The accuracy of each scoring system in predicting perioperative outcomes and postoperative complications was superior to that of tumor size.

Conclusions: Each scoring system has an advantage over tumor size in describing tumor complexity and may help with surgical decision making. Further studies are required to validate their efficacy in evaluating the intraoperative and postoperative results after renal laparoscopic radio frequency ablation.

Keywords: ablation techniques; kidney neoplasms; laparoscopy.

Publication types

Comparative Study

MeSH terms

Catheter Ablation*
Female
Humans
Kidney Neoplasms / classification
Kidney Neoplasms / pathology*
Kidney Neoplasms / surgery*
Laparoscopy*
Male
Middle Aged
Prognosis
Retrospective Studies
Tumor Burden