PADUA and RENAL Nephrometry Score Systems could not Predict Postoperative Outcomes after Partial Nephrectomy of Small Renal Masses in a Danish Cohort

Objective: We aimed to evaluate the efficacy of the two previously validated scoring systems PADUA (Preoperative Aspects and Dimensions Used for an Anatomical score), and RENAL (Radius, Exophytic/endophytic, Nearness, Anterior/posterior Location) in a Danish cohort, with regard to the postoperative outcomes after partial nephrectomy. We also evaluated the shortest distance between the margin of the tumor and renal vessels, termed DTV (Distance of the Tumor from renal hilus Vessel), as a possible novel and simple predictor of postoperative outcomes. Patients and methods: We collected retrospective data on 153 consecutive patients who underwent partial nephrectomy for small renal masses from January 2010 to December 2014. The median age was 67 years (range 33-82), 99 men and 54 women. All CT scans were initially evaluated by a radiologist and then re-evaluated by one urologist with measurement of all features included in the PADUA and RENAL score systems, as well as DTV. Outcomes were: bleeding, warm ischemia time, length of hospital stay, complication rates, and change in the estimated glomerular filtration rate (e-GFR) from before to after surgery. Results: Neither PADUA nor RENAL were statistically significant predictors of any outcome in this cohort. The same was true for DTV regarding bleeding (p=0.18), warm ischemia time (p=0.58), length of hospital stay (p=0.87), complication rate (p=0.59) and the changes in the e-GFR from before to after surgery (p=0.34). Conclusion: Neither the PADUA, the RENAL score systems nor could the DTV accurately predict the peri-or postoperative outcomes in our Danish cohort after laparoscopic partial nephrectomy of small renal masses.