The comparison of three renal tumor scoring systems: C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores

Zhamshid Okhunov, Soroush Rais-Bahrami, Arvin K. George, Nikhil Waingankar, Brian Duty, Sylvia Montag, Lisa Rosen, Suzanne Sunday, Manish A. Vira, Louis R. Kavoussi

Research output: Contribution to journalArticle

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Abstract

Background and Purpose: The centrality-index (C-Index), preoperative aspects and dimensions used for anatomic (P.A.D.U.A.) classification, and radius.exophyic/endophytic.nearness.anterior/posterior.location (R.E.N.A.L.) nephrometry schemes were developed as standardized scoring systems (SS) to quantify anatomic characteristics of kidney tumors. The objective of this study was to establish reliability and assess relationships between these three SS and perioperative and postoperative variables. Patients and Methods: A retrospective chart review was performed in 101 patients who underwent laparoscopic partial nephrectomy. The nephrometry schemes were correlated with intraoperative and postoperative parameters using Spearman correlations. In addition, interobserver reliability was assessed on 50 of the patients by interclass correlations comparing the scores assigned by two residents and one fellow who reviewed preoperative CT studies of these patients. Results: The interobserver correlation was 0.84 for the C-Index, 0.81 for the P.A.D.U.A., and 0.92 for the R.E.N.A.L. scoring systems, demonstrating excellent interobserver reliability. All three SS were significantly associated with warm ischemia time (WIT) (C-Index, P=-0.44; P.A.D.U.A., P=0.25; R.E.N.A.L., P=0.32) and percent change in creatinine level (C-Index, P=-0.33; P.A.D.U.A., P=0.37; R.E.N.A.L., P=0.37). There were no significant associations between any of the three SS assessed and the occurrence of complications, operative time, or estimated blood loss. No significant correlation was found between the P.A.D.U.A. and R.E.N.A.L. SS and length of stay; however, C-Index did show a significant relationship for patients with lower scores having longer hospital stays (P=-0.21). Conclusions: All three scoring systems demonstrated reliability among observers and represent novel methods of quantitatively describing renal tumors. They were all associated with WIT, percent change in creatinine level, and tumor size. They did not, however, correlate with any other perioperative parameters investigated. At this time, these SS provide a common language for describing renal tumors.

Original languageEnglish (US)
Pages (from-to)1921-1924
Number of pages4
JournalJournal of Endourology
Volume25
Issue number12
DOIs
StatePublished - Dec 1 2011
Externally publishedYes

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Kidney
Warm Ischemia
Neoplasms
Length of Stay
Creatinine
Operative Time
Nephrectomy
Language

ASJC Scopus subject areas

  • Urology

Cite this

Okhunov, Z., Rais-Bahrami, S., George, A. K., Waingankar, N., Duty, B., Montag, S., ... Kavoussi, L. R. (2011). The comparison of three renal tumor scoring systems: C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores. Journal of Endourology, 25(12), 1921-1924. https://doi.org/10.1089/end.2011.0301

The comparison of three renal tumor scoring systems : C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores. / Okhunov, Zhamshid; Rais-Bahrami, Soroush; George, Arvin K.; Waingankar, Nikhil; Duty, Brian; Montag, Sylvia; Rosen, Lisa; Sunday, Suzanne; Vira, Manish A.; Kavoussi, Louis R.

In: Journal of Endourology, Vol. 25, No. 12, 01.12.2011, p. 1921-1924.

Research output: Contribution to journalArticle

Okhunov, Z, Rais-Bahrami, S, George, AK, Waingankar, N, Duty, B, Montag, S, Rosen, L, Sunday, S, Vira, MA & Kavoussi, LR 2011, 'The comparison of three renal tumor scoring systems: C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores', Journal of Endourology, vol. 25, no. 12, pp. 1921-1924. https://doi.org/10.1089/end.2011.0301
Okhunov, Zhamshid ; Rais-Bahrami, Soroush ; George, Arvin K. ; Waingankar, Nikhil ; Duty, Brian ; Montag, Sylvia ; Rosen, Lisa ; Sunday, Suzanne ; Vira, Manish A. ; Kavoussi, Louis R. / The comparison of three renal tumor scoring systems : C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores. In: Journal of Endourology. 2011 ; Vol. 25, No. 12. pp. 1921-1924.
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title = "The comparison of three renal tumor scoring systems: C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores",
abstract = "Background and Purpose: The centrality-index (C-Index), preoperative aspects and dimensions used for anatomic (P.A.D.U.A.) classification, and radius.exophyic/endophytic.nearness.anterior/posterior.location (R.E.N.A.L.) nephrometry schemes were developed as standardized scoring systems (SS) to quantify anatomic characteristics of kidney tumors. The objective of this study was to establish reliability and assess relationships between these three SS and perioperative and postoperative variables. Patients and Methods: A retrospective chart review was performed in 101 patients who underwent laparoscopic partial nephrectomy. The nephrometry schemes were correlated with intraoperative and postoperative parameters using Spearman correlations. In addition, interobserver reliability was assessed on 50 of the patients by interclass correlations comparing the scores assigned by two residents and one fellow who reviewed preoperative CT studies of these patients. Results: The interobserver correlation was 0.84 for the C-Index, 0.81 for the P.A.D.U.A., and 0.92 for the R.E.N.A.L. scoring systems, demonstrating excellent interobserver reliability. All three SS were significantly associated with warm ischemia time (WIT) (C-Index, P=-0.44; P.A.D.U.A., P=0.25; R.E.N.A.L., P=0.32) and percent change in creatinine level (C-Index, P=-0.33; P.A.D.U.A., P=0.37; R.E.N.A.L., P=0.37). There were no significant associations between any of the three SS assessed and the occurrence of complications, operative time, or estimated blood loss. No significant correlation was found between the P.A.D.U.A. and R.E.N.A.L. SS and length of stay; however, C-Index did show a significant relationship for patients with lower scores having longer hospital stays (P=-0.21). Conclusions: All three scoring systems demonstrated reliability among observers and represent novel methods of quantitatively describing renal tumors. They were all associated with WIT, percent change in creatinine level, and tumor size. They did not, however, correlate with any other perioperative parameters investigated. At this time, these SS provide a common language for describing renal tumors.",
author = "Zhamshid Okhunov and Soroush Rais-Bahrami and George, {Arvin K.} and Nikhil Waingankar and Brian Duty and Sylvia Montag and Lisa Rosen and Suzanne Sunday and Vira, {Manish A.} and Kavoussi, {Louis R.}",
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T1 - The comparison of three renal tumor scoring systems

T2 - C-index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores

AU - Okhunov, Zhamshid

AU - Rais-Bahrami, Soroush

AU - George, Arvin K.

AU - Waingankar, Nikhil

AU - Duty, Brian

AU - Montag, Sylvia

AU - Rosen, Lisa

AU - Sunday, Suzanne

AU - Vira, Manish A.

AU - Kavoussi, Louis R.

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Background and Purpose: The centrality-index (C-Index), preoperative aspects and dimensions used for anatomic (P.A.D.U.A.) classification, and radius.exophyic/endophytic.nearness.anterior/posterior.location (R.E.N.A.L.) nephrometry schemes were developed as standardized scoring systems (SS) to quantify anatomic characteristics of kidney tumors. The objective of this study was to establish reliability and assess relationships between these three SS and perioperative and postoperative variables. Patients and Methods: A retrospective chart review was performed in 101 patients who underwent laparoscopic partial nephrectomy. The nephrometry schemes were correlated with intraoperative and postoperative parameters using Spearman correlations. In addition, interobserver reliability was assessed on 50 of the patients by interclass correlations comparing the scores assigned by two residents and one fellow who reviewed preoperative CT studies of these patients. Results: The interobserver correlation was 0.84 for the C-Index, 0.81 for the P.A.D.U.A., and 0.92 for the R.E.N.A.L. scoring systems, demonstrating excellent interobserver reliability. All three SS were significantly associated with warm ischemia time (WIT) (C-Index, P=-0.44; P.A.D.U.A., P=0.25; R.E.N.A.L., P=0.32) and percent change in creatinine level (C-Index, P=-0.33; P.A.D.U.A., P=0.37; R.E.N.A.L., P=0.37). There were no significant associations between any of the three SS assessed and the occurrence of complications, operative time, or estimated blood loss. No significant correlation was found between the P.A.D.U.A. and R.E.N.A.L. SS and length of stay; however, C-Index did show a significant relationship for patients with lower scores having longer hospital stays (P=-0.21). Conclusions: All three scoring systems demonstrated reliability among observers and represent novel methods of quantitatively describing renal tumors. They were all associated with WIT, percent change in creatinine level, and tumor size. They did not, however, correlate with any other perioperative parameters investigated. At this time, these SS provide a common language for describing renal tumors.

AB - Background and Purpose: The centrality-index (C-Index), preoperative aspects and dimensions used for anatomic (P.A.D.U.A.) classification, and radius.exophyic/endophytic.nearness.anterior/posterior.location (R.E.N.A.L.) nephrometry schemes were developed as standardized scoring systems (SS) to quantify anatomic characteristics of kidney tumors. The objective of this study was to establish reliability and assess relationships between these three SS and perioperative and postoperative variables. Patients and Methods: A retrospective chart review was performed in 101 patients who underwent laparoscopic partial nephrectomy. The nephrometry schemes were correlated with intraoperative and postoperative parameters using Spearman correlations. In addition, interobserver reliability was assessed on 50 of the patients by interclass correlations comparing the scores assigned by two residents and one fellow who reviewed preoperative CT studies of these patients. Results: The interobserver correlation was 0.84 for the C-Index, 0.81 for the P.A.D.U.A., and 0.92 for the R.E.N.A.L. scoring systems, demonstrating excellent interobserver reliability. All three SS were significantly associated with warm ischemia time (WIT) (C-Index, P=-0.44; P.A.D.U.A., P=0.25; R.E.N.A.L., P=0.32) and percent change in creatinine level (C-Index, P=-0.33; P.A.D.U.A., P=0.37; R.E.N.A.L., P=0.37). There were no significant associations between any of the three SS assessed and the occurrence of complications, operative time, or estimated blood loss. No significant correlation was found between the P.A.D.U.A. and R.E.N.A.L. SS and length of stay; however, C-Index did show a significant relationship for patients with lower scores having longer hospital stays (P=-0.21). Conclusions: All three scoring systems demonstrated reliability among observers and represent novel methods of quantitatively describing renal tumors. They were all associated with WIT, percent change in creatinine level, and tumor size. They did not, however, correlate with any other perioperative parameters investigated. At this time, these SS provide a common language for describing renal tumors.

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