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Renal tumor contact surface area: a novel parameter for predicting complexity and outcomes of partial nephrectomy.

Abstract：

BACKGROUND:The contact surface area (CSA) of a tumor with adjacent renal parenchyma may determine the complexity and thus the perioperative outcomes of partial nephrectomy (PN). OBJECTIVE:We devised a novel imaging parameter, renal tumor CSA, and correlate it with perioperative outcomes in patients undergoing PN. DESIGN, SETTING, AND PARTICIPANTS:Of 200 patients undergoing PN for a tumor (January 2010 to August 2011), 162 had renal protocol computed tomography scanning data available. CSA was calculated using image-rendering software (Synapse 3D, Fujifilm), and interobserver variability was determined between three independent observers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:CSA was correlated to baseline demographics and perioperative outcomes as a continuous and categorical variable using multivariable logistic regression analysis. The ability of CSA to predict adverse perioperative events was compared with demographic factors and nephrometry scoring systems. RESULTS AND LIMITATIONS:The mean tumor size was 3.1cm; CSA was 18.3 cm(2). CSA ≥20 cm(2) correlated with adverse tumor characteristics (greater tumor size, volume, and complexity) and perioperative outcomes (more parenchymal volume loss, blood loss, and complications) compared with CSA <20 cm(2). On multivariable logistic regression, CSA independently predicted operative time, complications, hospital stay, and renal functional outcomes. This predictive ability of CSA was superior to the other parameters evaluated. CONCLUSIONS:CSA is a novel imaging parameter that quantifies the CSA of renal tumor with adjacent parenchyma. Our preliminary data indicate that CSA correlates with PN outcomes. If validated externally in a larger cohort, CSA could be incorporated into future versions of nephrometry scoring systems. PATIENT SUMMARY:In this study we outline the method of calculating the contact surface area (CSA) of renal tumors with the surrounding normal kidney using image-rendering software. We found that CSA correlates with a number of important surgical outcomes including operative time, loss of renal function, and complications.

journal_name

Eur Urol

journal_title

European urology

authors

Leslie S,Gill IS,de Castro Abreu AL,Rahmanuddin S,Gill KS,Nguyen M,Berger AK,Goh AC,Cai J,Duddalwar VA,Aron M,Desai MM

doi

10.1016/j.eururo.2014.03.010

subject

Has Abstract

pub_date

2014-11-01 00:00:00

pages

884-93

issue

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(14)00246-2

journal_volume

pub_type

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Renal tumor contact surface area: a novel parameter for predicting complexity and outcomes of partial nephrectomy.