Improved prediction of nephron-sparing surgery versus radical nephrectomy by the optimized R.E.N.A.L. Score in patients undergoing surgery for renal masses.

摘要: BACKGROUND One major objective of currently available morphometric scores (MS) for renal masses, i.e., R.E.N.A.L., PADUA classification, Centrality-Index, is the prediction type surgery (nephron-sparin [NSS] or radical nephrectomy [RN]). METHODS Based on a prospective study protocol, various MS were assigned and calculated 108 patients undergoing surgical treatment masses at single academic center. calculation was based preoperative computed-tomography magnet-resonance-imaging performed by two independent readers blinded approach outcome. Multivariable logistic-regression- ROC-analyses to assess predictive value correlation clinical parameters with type. Furthermore, association perioperative outcome evaluated. RESULTS None tested significantly superior tumor size alone (area under curve [AUC]=0.82) in predicting RN, Centrality-Index showing best (AUC=0.88). these findings, simplified optimized R.E.N.A.L. Score (optR.E.N.A.L.) developed different weightings included parameters, which did not only show enhanced (AUC=0.93) than size, but also outperformed all 1st 2nd generation cohort. Besides modest postoperative change function, no variables found including optR.E.N.A.L. CONCLUSIONS represents promising improvement preexisting higher ability established may serve as benchmarking tool assessment comparison strategies.