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2015 ; 10
(11
): e0141709
Nephropedia Template TP
gab.com Text
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English Wikipedia
Trends in the Use of Nephron-Sparing Surgery over 7 Years: An Analysis Using the
R E N A L Nephrometry Scoring System
#MMPMID26599436
Shin SJ
; Ko KJ
; Kim TS
; Ryoo HS
; Sung HH
; Jeon HG
; Jeong BC
; Seo SI
; Lee HM
; Choi HY
; Jeon SS
PLoS One
2015[]; 10
(11
): e0141709
PMID26599436
show ga
OBJECTIVE: To analyze trends in the use of partial nephrectomy, we evaluated
which individual factors of renal nephrometry score (RNS) influenced the
operative approach bi-annually from 2008 to 2014. MATERIALS AND METHODS: We
performed a retrospective review of renal cell carcinoma treated by surgery in
2008, 2010, 2012, and 2014. The complexity of renal masses was measured using the
R.E.N.A.L. nephrometry scoring system with CT or MRI. Group comparison in terms
of operation year and surgical type (partial nephrectomy versus radical
nephrectomy) was performed. We developed a nomogram to quantitate the likelihood
of selecting partial nephrectomy over radical nephrectomy. RESULTS: A total of
1106 cases (237 in 2008, 225 in 2010, 292 in 2012, and 352 in 2014) were
available for the study. Over the study period, the proportion of partial
nephrectomies performed increased steadily from 21.5% in 2008 to 66.5% in 2014 (p
< 0.05). Furthermore, use of partial nephrectomy increased steadily in all RNS
complexity groups (low, moderate, and high) (p < 0.05). In the analysis of
individual components of RNS, values of the R and N components increased
statistically by year in the partial nephrectomy group (p < 0.05). Average AUC
was 0.920. CONCLUSIONS: The proportion of partial nephrectomies performed sharply
increased over the study period. Additionally, over the study period, more
partial nephrectomies were performed for renal masses of larger size and closer
to the collecting system and main renal vessels. A nomogram developed based on
this recent data set provides significant predictive value for surgical decision
making.