Practical and Intuitive Surgical Approach Renal Ranking (SARR) to predict outcomes in the treatment of renal tumors: a novel score tool.

Universidade Federal de São Paulo - UNIFESP, Urology, Dr. Diogo de Faria, 671, Vila Clementino, São Paulo, SP, Brazil, 04037000, +557188800925 ; .
Journal of endourology / Endourological Society (Impact Factor: 1.75). 11/2013; DOI: 10.1089/end.2013-0148.ECB13
Source: PubMed

ABSTRACT Background and Purpose: Surgery continues to be the main form of treatment for renal tumors. We create a more practical and intuitive score for renal tumor classification. Materials and Methods: 80 patients underwent surgery for renal tumors and were prospectively enrolled. The tumors were classified using the following variables: (1) tumor size, (2) endophytic or exophytic tumor, (3) longitudinal location of the tumor, (4) the extent of the impairment renal parenchyma, (5) relationship with the renal sinus, (6) anterior or posterior. Results: The mean operative time, tumor size and bleeding increased proportionally to the increased complexity of the tumor measured by scores (p<0.0001, p<0.0001 and p=0.036, respectively). The mean total score was 8.7 points for patients undergoing partial nephrectomy (PN) and 14.4 points for those undergoing radical nephrectomy (RN) (p<0.0001). Larger tumors, completely endophytic, which exceeded the renal medulla and centrally located underwent radical nephrectomy (RN) more often (86.7% - p<0.0001, 64% - p=0.01, 77% - p<0.0001 and 78.9% - p<0.0001, respectively). In univariate analysis, RN was associated with tumors larger than 7 cm (p=0.001), tumors that exceeded the renal medullary (<0.001), centrally located tumors (OR=150 p <0.001) and tumors of high complexity (p<0.001). Analysis showed no association between complications and variables in the score. The findings were similar when the tumors were evaluated with the R.E.N.A.L. score system. Conclusion: SARR is a simple, practical and intuitive classification for renal tumors that can be used in the decision-making process and to predict outcomes in the surgical treatment of renal tumors.

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Aug 7, 2014