Change in nephrometry scoring in small renal masses (<4cm) on active surveillance: observations from tayside active surveillance cohort (TASC) study
BAUS ePoster online library. Zhang W.
Jun 27, 2018; 211377
Wanzhe Zhang
Wanzhe Zhang
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Objectives: Prediction of growth, in particular knowing 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 (SRMs) opting for active surveillance initially.

Patients and Methods: One hundred sixteen patients between January 2000 and December 2016 undergoing partial nephrectomy were analyzed using different nephrometry scoring systems. Measurement of nephrometry scores (RENAL, PADUA, C-Index) was performed by two researchers. Amongst the patients opting for partial nephrectomy, 40 were on active surveillance for at least 12 months (mean 32; 12-60 months) prior to partial nephrectomy. CT scan images of these patients were retrieved and analysed including comparison with histopathology.

Results: Nephrometry scores measured on serial CT scan images showed a significant correlation between change in score and grade of cancer on multivariate analysis (p-value 0.001). Addition of multivariate analysis to nomogram based on change in size alone improved predictive value of AUC from 0.58 to 0.65.

Conclusions: Change in nephrometry scoring measurements can accurately predict presence of malignancy and grade of cancer in patients opting for active surveillance.
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