1. Simplified PADUA renal (SPARE) nephrometry score validation and long-term outcomes after robot-assisted partial nephrectomy
- Author
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Dries Develtere, Marco Amato, Alexandre Mottrie, Umberto Capitanio, Camille Berquin, Rui Farinha, Geert De Naeyer, Alberto Briganti, Celine Sinatti, Ruben De Groote, Stefano Puliatti, Frederiek D'Hondt, Francesco Montorsi, Alessandro Larcher, Elio Mazzone, Peter Schatteman, Pietro Piazza, Victor Tames, and Giuseppe Rosiello
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Renal function ,Nephrectomy ,Robotic Surgical Procedures ,Linear regression ,medicine ,Renal mass ,Humans ,Minimally-invasive ,Prospective Studies ,Aged ,integumentary system ,Anatomic scores ,Kidney cancer ,Small renal mass ,business.industry ,Acute kidney injury ,Robotics ,Odds ratio ,Middle Aged ,medicine.disease ,Kidney Neoplasms ,Treatment Outcome ,Oncology ,Spare part ,Female ,business ,Nephrotomy - Abstract
International guidelines suggest the use of anatomic scores to predict surgical outcomes after partial nephrectomy (PN). We aimed at validating the use of Simplified PADUA Renal (SPARE) nephrometry score in robot-assisted PN (RAPN).Three hundred and sixty-eight consecutive RAPN patients were included. Primary endpoints were overall complications, postoperative acute kidney injury (AKI) and TRIFECTA achievement. Secondary endpoint was estimated glomerular filtration rate (eGFR) decrease at last follow-up. Multivariable logistic and linear regression models were used.Of 368 patients, 229 (62%) vs. 116 (31%) vs. 23 (6.2%) harboured low- vs. intermediate- vs. high-risk renal mass, according to SPARE classification. SPARE score predicted higher risk of overall complications (Odds ratio [OR]: 1.23, 95%CI 1.09-1.39; P0.001), and postoperative AKI (OR: 1.20, 95%CI 1.08-1.35; P0.01). Moreover, SPARE score was associated with lower TRIFECTA achievement (OR: 0.89, 95%CI 0.81-0.98; P = 0.02). Predicted accuracy was 0.643, 0.614 and 0.613, respectively. After a median follow-up of 40 (IQR: 21-66) months, eGFR decrease ranged from -7% in low-risk to -17% in high-risk SPARE.SPARE scoring system predicts surgical success in RAPN patients. Moreover, SPARE score is associated with eGFR decrease at long-term follow-up. Thus, the adoption of SPARE score to objectively assess tumor complexity prior to RAPN may be preferable.
- Published
- 2022
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