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Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score

Our objective was to develop a new, simple, and ablation-specific nephrometry score to predict peri-operative outcomes and to compare its predictive accuracy to PADUA and RENAL scores. Overall, 418 patients were treated with percutaneous thermal ablation (microwave and radiofrequency) between 2008 a...

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Autores principales: Musi, Gennaro, Luzzago, Stefano, Mauri, Giovanni, Mistretta, Francesco Alessandro, Varano, Gianluca Maria, Vaccaro, Chiara, Guzzo, Sonia, Maiettini, Daniele, Di Trapani, Ettore, Della Vigna, Paolo, Bianchi, Roberto, Bonomo, Guido, Ferro, Matteo, Tian, Zhe, Karakiewicz, Pierre I., de Cobelli, Ottavio, Orsi, Franco, Piccinelli, Mattia Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10528095/
https://www.ncbi.nlm.nih.gov/pubmed/37761322
http://dx.doi.org/10.3390/diagnostics13182955
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author Musi, Gennaro
Luzzago, Stefano
Mauri, Giovanni
Mistretta, Francesco Alessandro
Varano, Gianluca Maria
Vaccaro, Chiara
Guzzo, Sonia
Maiettini, Daniele
Di Trapani, Ettore
Della Vigna, Paolo
Bianchi, Roberto
Bonomo, Guido
Ferro, Matteo
Tian, Zhe
Karakiewicz, Pierre I.
de Cobelli, Ottavio
Orsi, Franco
Piccinelli, Mattia Luca
author_facet Musi, Gennaro
Luzzago, Stefano
Mauri, Giovanni
Mistretta, Francesco Alessandro
Varano, Gianluca Maria
Vaccaro, Chiara
Guzzo, Sonia
Maiettini, Daniele
Di Trapani, Ettore
Della Vigna, Paolo
Bianchi, Roberto
Bonomo, Guido
Ferro, Matteo
Tian, Zhe
Karakiewicz, Pierre I.
de Cobelli, Ottavio
Orsi, Franco
Piccinelli, Mattia Luca
author_sort Musi, Gennaro
collection PubMed
description Our objective was to develop a new, simple, and ablation-specific nephrometry score to predict peri-operative outcomes and to compare its predictive accuracy to PADUA and RENAL scores. Overall, 418 patients were treated with percutaneous thermal ablation (microwave and radiofrequency) between 2008 and 2021. The outcome of interest was trifecta status (achieved vs. not achieved): incomplete ablation or Clavien–Dindo ≥ 3 complications or postoperative estimated glomerular filtration rate decrease ≥ 30%. First, we validated the discrimination ability of the PADUA and RENAL scoring systems. Second, we created and internally validated a novel scoring (SuNS) system, according to multivariable logistic regression models. The predictive accuracy of the model was tested in terms of discrimination and calibration. Overall, 89 (21%) patients did not achieve trifecta. PADUA and RENAL scores showed poor ability to predict trifecta status (c-indexes 0.60 [0.53–0.67] and 0.62 [0.55–0.69], respectively). We, therefore, developed the SuNS model (c-index: 0.74 [0.67–0.79]) based on: (1) contact surface area; (2) nearness to renal sinus or urinary collecting system; (3) tumour diameter. Three complexity classes were created: low (3–4 points; 11% of no trifecta) vs. moderate (5–6 points; 30% of no trifecta) vs. high (7–8 points; 65% of no trifecta) complexity. Limitations include the retrospective and single-institution nature of the study. In conclusion, we developed an immediate, simple, and reproducible ablation-specific nephrometry score (SuNS) that outperformed PADUA and RENAL nephrometry scores in predicting peri-operative outcomes. External validation is required before daily practice implementation.
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spelling pubmed-105280952023-09-28 Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score Musi, Gennaro Luzzago, Stefano Mauri, Giovanni Mistretta, Francesco Alessandro Varano, Gianluca Maria Vaccaro, Chiara Guzzo, Sonia Maiettini, Daniele Di Trapani, Ettore Della Vigna, Paolo Bianchi, Roberto Bonomo, Guido Ferro, Matteo Tian, Zhe Karakiewicz, Pierre I. de Cobelli, Ottavio Orsi, Franco Piccinelli, Mattia Luca Diagnostics (Basel) Article Our objective was to develop a new, simple, and ablation-specific nephrometry score to predict peri-operative outcomes and to compare its predictive accuracy to PADUA and RENAL scores. Overall, 418 patients were treated with percutaneous thermal ablation (microwave and radiofrequency) between 2008 and 2021. The outcome of interest was trifecta status (achieved vs. not achieved): incomplete ablation or Clavien–Dindo ≥ 3 complications or postoperative estimated glomerular filtration rate decrease ≥ 30%. First, we validated the discrimination ability of the PADUA and RENAL scoring systems. Second, we created and internally validated a novel scoring (SuNS) system, according to multivariable logistic regression models. The predictive accuracy of the model was tested in terms of discrimination and calibration. Overall, 89 (21%) patients did not achieve trifecta. PADUA and RENAL scores showed poor ability to predict trifecta status (c-indexes 0.60 [0.53–0.67] and 0.62 [0.55–0.69], respectively). We, therefore, developed the SuNS model (c-index: 0.74 [0.67–0.79]) based on: (1) contact surface area; (2) nearness to renal sinus or urinary collecting system; (3) tumour diameter. Three complexity classes were created: low (3–4 points; 11% of no trifecta) vs. moderate (5–6 points; 30% of no trifecta) vs. high (7–8 points; 65% of no trifecta) complexity. Limitations include the retrospective and single-institution nature of the study. In conclusion, we developed an immediate, simple, and reproducible ablation-specific nephrometry score (SuNS) that outperformed PADUA and RENAL nephrometry scores in predicting peri-operative outcomes. External validation is required before daily practice implementation. MDPI 2023-09-15 /pmc/articles/PMC10528095/ /pubmed/37761322 http://dx.doi.org/10.3390/diagnostics13182955 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Musi, Gennaro
Luzzago, Stefano
Mauri, Giovanni
Mistretta, Francesco Alessandro
Varano, Gianluca Maria
Vaccaro, Chiara
Guzzo, Sonia
Maiettini, Daniele
Di Trapani, Ettore
Della Vigna, Paolo
Bianchi, Roberto
Bonomo, Guido
Ferro, Matteo
Tian, Zhe
Karakiewicz, Pierre I.
de Cobelli, Ottavio
Orsi, Franco
Piccinelli, Mattia Luca
Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title_full Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title_fullStr Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title_full_unstemmed Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title_short Predicting Peri-Operative Outcomes in Patients Treated with Percutaneous Thermal Ablation for Small Renal Masses: The SuNS Nephrometry Score
title_sort predicting peri-operative outcomes in patients treated with percutaneous thermal ablation for small renal masses: the suns nephrometry score
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10528095/
https://www.ncbi.nlm.nih.gov/pubmed/37761322
http://dx.doi.org/10.3390/diagnostics13182955
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