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Change in nephrometry scoring in small renal masses ( < 4 cm) on active surveillance: preliminary observations from Tayside Active Surveillance Cohort (TASC) study.

Khan, Mohammed H.; Zhang, Wanzhe; Paterson, Catherine; Szewczyk-Bieda, Magda; Lang, Stephen; Nabi, Ghulam

Authors

Mohammed H. Khan

Wanzhe Zhang

Catherine Paterson

Magda Szewczyk-Bieda

Stephen Lang

Ghulam Nabi



Abstract

Rationale and Objectives: - Prediction of growth, in particular knowing the possibility of aggressive cancer in small renal masses on active surveillance, remains poorly understood. The study was designed to determine whether serial nephrometry score measurements could predict possibility of aggressive malignancy (grade of cancer) in patients with small renal masses opting for active surveillance initially. Materials and Methods: - One hundred sixteen patients between January 2000 and December 2016 undergoing partial nephrectomy were recruited. Out of these, 97 were analyzed using different nephrometry scoring systems. Measurement of nephrometry scores (Radius of tumors, Exo/Endophytic; Nearness of tumors to the collecting system or sinus; Anterior/posterior; Location in relation to polar lines, Preoperative Aspects and Dimensions Used for Anatomical, Centrality Index) was performed by two researchers. Among the patients opting for partial nephrectomy, 40 were on active surveillance for at least 12 months (mean 32; 12-60 months) before partial nephrectomy. Computed tomography scan images of these patients were retrieved and analyzed including comparison to histopathology. Results: - Nephrometry scores measured on serial computed tomography scan images showed a significant correlation between change in score and grade of cancer on multivariate analysis (P value .001). Addition of multivariate analysis to nomogram based on change in size alone did not improve predictive value of area under the curve significantly. Conclusions: - Change in nephrometry scoring measurements correlates with grade of cancer in small renal masses but falls short of significantly predicting presence of malignancy or grade of cancer on nomogram in patients opting for active surveillance for small renal masses. At present, this approach may be inadequate for decision-making.

Citation

KHAN, K.H., ZHANG, W., PATERSON, C., SZEWCZYK-BIEDA, M., LANG, S. and NABI, G. 2018. Change in nephrometry scoring in small renal masses ( < 4 cm) on active surveillance: preliminary observations from Tayside Active Surveillance Cohort (TASC) study. Academic radiology [online], 25(11), pages 1381-1387. Available from: https://doi.org/10.1016/j.acra.2018.02.001

Journal Article Type Article
Acceptance Date Feb 1, 2018
Online Publication Date Mar 6, 2018
Publication Date Nov 30, 2018
Deposit Date Mar 15, 2018
Publicly Available Date Mar 7, 2019
Journal Academic Radiology
Print ISSN 1076-6332
Electronic ISSN 1878-4046
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 25
Issue 11
Pages 1381-1387
DOI https://doi.org/10.1016/j.acra.2018.02.001
Keywords Kidney; Partial nephrectomy; Nephrometry score; Complications
Public URL http://hdl.handle.net/10059/2802