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Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass

PURPOSE: To accurately describe the three-dimensional topology of renal tumors, our study suggests a new nephrometry scoring system, the T-index, that combines information about intraparenchymal extension and peripherality of the renal tumor. MATERIALS AND METHODS: This study included 113 patients w...

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Autores principales: An, Dongkyu, Jung, Dae Chul, Lee, Jungwook, Han, Kyunghwa, Lee, Seungsoo, Chang, Ki Don, Rha, Koon Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Urological Association 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10482659/
https://www.ncbi.nlm.nih.gov/pubmed/37668200
http://dx.doi.org/10.4111/icu.20230041
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author An, Dongkyu
Jung, Dae Chul
Lee, Jungwook
Han, Kyunghwa
Lee, Seungsoo
Chang, Ki Don
Rha, Koon Ho
author_facet An, Dongkyu
Jung, Dae Chul
Lee, Jungwook
Han, Kyunghwa
Lee, Seungsoo
Chang, Ki Don
Rha, Koon Ho
author_sort An, Dongkyu
collection PubMed
description PURPOSE: To accurately describe the three-dimensional topology of renal tumors, our study suggests a new nephrometry scoring system, the T-index, that combines information about intraparenchymal extension and peripherality of the renal tumor. MATERIALS AND METHODS: This study included 113 patients who underwent partial nephrectomy for small clear cell renal cell carcinoma between 2007 and 2014. Manual segmentation of the renal parenchyma, sinus, and tumor was performed using preoperative computed tomography images. The T-index was calculated by adding the reciprocals of the distances from all points on the tumor-parenchyma interface to the renal sinus. Correlations with perioperative factors and the impact of the T-index on postoperative complications were evaluated and compared with existing nephrometry scoring systems (PADUA, RENAL, contact surface area [CSA], and C-index). RESULTS: The mean value of the T-index among the 113 patients was 116.1±100.5 (1/mm). The T-index showed the strongest correlation with perioperative factors compared with other nephrometry scoring systems. The T-index was able to predict the risk for postoperative complications, either overall (p=0.015) or major complications (p=0.030). A predictive model based on the T-index of the overall postoperative complications presented the best performance (area under the curve, 0.692; 95% CI, 0.599–0.776) compared with other nephrometry scoring systems. CONCLUSIONS: The T-index can be considered as a single value comprising key structural indicators for surgical complexity. Our findings suggest that the T-index can provide a quantitative and objective scoring system associated with surgical difficulty and postoperative complications of partial nephrectomy.
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spelling pubmed-104826592023-09-08 Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass An, Dongkyu Jung, Dae Chul Lee, Jungwook Han, Kyunghwa Lee, Seungsoo Chang, Ki Don Rha, Koon Ho Investig Clin Urol Original Article PURPOSE: To accurately describe the three-dimensional topology of renal tumors, our study suggests a new nephrometry scoring system, the T-index, that combines information about intraparenchymal extension and peripherality of the renal tumor. MATERIALS AND METHODS: This study included 113 patients who underwent partial nephrectomy for small clear cell renal cell carcinoma between 2007 and 2014. Manual segmentation of the renal parenchyma, sinus, and tumor was performed using preoperative computed tomography images. The T-index was calculated by adding the reciprocals of the distances from all points on the tumor-parenchyma interface to the renal sinus. Correlations with perioperative factors and the impact of the T-index on postoperative complications were evaluated and compared with existing nephrometry scoring systems (PADUA, RENAL, contact surface area [CSA], and C-index). RESULTS: The mean value of the T-index among the 113 patients was 116.1±100.5 (1/mm). The T-index showed the strongest correlation with perioperative factors compared with other nephrometry scoring systems. The T-index was able to predict the risk for postoperative complications, either overall (p=0.015) or major complications (p=0.030). A predictive model based on the T-index of the overall postoperative complications presented the best performance (area under the curve, 0.692; 95% CI, 0.599–0.776) compared with other nephrometry scoring systems. CONCLUSIONS: The T-index can be considered as a single value comprising key structural indicators for surgical complexity. Our findings suggest that the T-index can provide a quantitative and objective scoring system associated with surgical difficulty and postoperative complications of partial nephrectomy. The Korean Urological Association 2023-09 2023-08-28 /pmc/articles/PMC10482659/ /pubmed/37668200 http://dx.doi.org/10.4111/icu.20230041 Text en © The Korean Urological Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
An, Dongkyu
Jung, Dae Chul
Lee, Jungwook
Han, Kyunghwa
Lee, Seungsoo
Chang, Ki Don
Rha, Koon Ho
Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title_full Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title_fullStr Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title_full_unstemmed Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title_short Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
title_sort three-dimensional topology-based t-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10482659/
https://www.ncbi.nlm.nih.gov/pubmed/37668200
http://dx.doi.org/10.4111/icu.20230041
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