Renal Tumor Invasion Depth and Diameter are the Two Most Accurate Anatomical Features Regarding the Choice of Radical Versus Partial Nephrectomy

Show full item record



Permalink

http://hdl.handle.net/10138/301788

Citation

Tornberg , S V , Kilpeläinen , T P , Järvinen , P , Visapää , H , Järvinen , R , Taari , K & Nisén , H 2018 , ' Renal Tumor Invasion Depth and Diameter are the Two Most Accurate Anatomical Features Regarding the Choice of Radical Versus Partial Nephrectomy ' , Scandinavian Journal of Surgery , vol. 107 , no. 1 , pp. 54-61 . https://doi.org/10.1177/1457496917731186

Title: Renal Tumor Invasion Depth and Diameter are the Two Most Accurate Anatomical Features Regarding the Choice of Radical Versus Partial Nephrectomy
Author: Tornberg, S. V.; Kilpeläinen, T. P.; Järvinen, P.; Visapää, H.; Järvinen, R.; Taari, K.; Nisén, H.
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Urologian yksikkö
University of Helsinki, Urologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Urologian yksikkö
Date: 2018-03
Language: eng
Number of pages: 8
Belongs to series: Scandinavian Journal of Surgery
ISSN: 1457-4969
URI: http://hdl.handle.net/10138/301788
Abstract: Background and Aims: To evaluate simple tumor characteristics (renal tumor diameter and parenchymal invasion depth) compared with more complex classifications, that is, Renal Tumor Invasion Index (RTII) and Preoperative Aspects and Dimensions Used for an Anatomical classification, in predicting the type of nephrectomy (radical vs partial) performed. Material and Methods: A total of 915 patients who had undergone either partial nephrectomy (n=388, 42%) or radical nephrectomy (n=527, 58%) were identified from the Helsinki University Hospital kidney tumor database between 1 January 2006 and 31 December 2014. Tumor maximum diameter and depth of invasion into the parenchyma were estimated from computed tomography or magnetic resonance imaging images and compared with Preoperative Aspects and Dimensions Used for an Anatomical and Renal Tumor Invasion Index. Logistic regression and receiver operating curves were used to compare the parameters at predicting the type of nephrectomy. Results and conclusion: All the anatomical variables of receiver operating curve/area under the curve analyses were significant predictors for the type of nephrectomy. Parenchymal invasion (area under the curve 0.91; 95% confidence interval, 0.89-0.93), RTII (area under the curve 0.91; 95% confidence interval, 0.89-0.93), and diameter (area under the curve 0.91; 95% confidence interval, 0.89-0.93) performed significantly better than Preoperative Aspects and Dimensions Used for an Anatomical classification (area under the curve 0.88; 95% confidence interval, 0.85-0.89). In multivariable analysis, invasion depth was the best predictor of nephrectomy type (percentage correct, 85.6%). Addition of one anatomic parameter into the model of non-anatomical cofactors improved the accuracy of the model significantly, but the addition of more parameters did not. Parenchymal invasion depth and tumor diameter are the most accurate anatomical features for predicting the nephrectomy type. All potential anatomical classification systems should be tested against these two simple characteristics.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
urologia
Tumor invasion
diameter
invasion index
Preoperative Aspects and Dimensions Used for an Anatomical
nephrectomy
renal cell
ASSISTED PARTIAL NEPHRECTOMY
NEPHROMETRY SCORING SYSTEM
PERIOPERATIVE COMPLICATIONS
PREDICTING COMPLEXITY
OUTCOMES
MANAGEMENT
INDEX
MASSES
ASSOCIATION
R.E.N.A.L.
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
1457496917731186.pdf 389.2Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record