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Urology. 2015 Jan;85(1):125-9. doi: 10.1016/j.urology.2014.08.026. Epub 2014 Oct 18.

The performance of a modified RENAL nephrometry score in predicting renal mass radiofrequency ablation success.

Author information

1
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.
2
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
3
Department of Urology, Robert Wood Johnson University Hospital, New Brunswick, NJ.
4
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: jeffrey.cadeddu@utsouthwestern.edu.

Abstract

OBJECTIVE:

To assess the predictive performance of a modified RENAL nephrometry score for renal tumors undergoing radiofrequency ablation (RFA).

METHODS:

Patients who underwent RFA were identified from 2002 to 2011, and RENAL nephrometry scoring was performed for each. A modified RENAL (m-RENAL) nephrometry score was created to account for the small sizes of tumors ablated for which the size variable, R, was adjusted. A size of 3 cm was calculated as the optimal cutoff for the R component of the m-RENAL nephrometry score, and tumors were given an R score of 1 if <3 cm, 2 if 3-4 cm, or 3 if >4 cm. Other RENAL variables were unchanged. Oncologic outcomes were stratified by complexity tertiles defined as low (4-6), medium (7-9), and high (10-12). Outcomes were reported as initial ablation success (IAS), recurrence-free survival (RFS), and metastatic-free survival (MFS). The Kaplan-Meir method was used to estimate survival based on complexity tertile.

RESULTS:

Two hundred forty patients were identified who underwent RFA, of which 192 patients were eligible for analysis. Median follow-up was 32.2 months, and median tumor size was 2.4 cm. IAS was achieved in 185 of 192 patients (96.4%). Overall, the estimated 3-year RFS was 95.1% and MFS was 97.3%. There was no statistical difference between complexity tertiles using the standard RENAL nephrometry score; however, the m-RENAL nephrometry score was significantly associated with IAS and RFS (P = .027 and P = .003, respectively). There were too few events (n = 3) to perform statistical analysis for MFS.

CONCLUSION:

A modification to the size variable increases the performance of the RENAL nephrometry score when used to stratify RFA ablation success.

PMID:
25440815
DOI:
10.1016/j.urology.2014.08.026
[Indexed for MEDLINE]

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