PD40-10 FORMAL VALIDATION AT FINAL PATHOLOGY AFTER RADICAL NEHRECTOMY OF NEPHROMETRY SCORES: DISCORDANCE RATES AND OVERTREATMENT RISK

You have accessJournal of UrologyCME1 May 2022PD40-10 FORMAL VALIDATION AT FINAL PATHOLOGY AFTER RADICAL NEHRECTOMY OF NEPHROMETRY SCORES: DISCORDANCE RATES AND OVERTREATMENT RISK Francesco Cei, Giacomo Musso, Giuseppe Rosiello, Giuseppe Fallara, Daniele Cignoli, Giuseppe Basile, Gianmarco Colandrea, Gianfranco Baiamonte, Federico Belladelli, Isaline Rowe, Daniela Canibus, Chiara Re, Roberta Lucianò, Maurizio Colecchia, Francesco De Cobelli, Giorgio Brembilla, Federico Dehò, Vincenzo Mirone, Alberto Briganti, Roberto Bertini, Francesco Montorsi, Andrea Salonia, Alessandro Larcher, and Umberto Capitanio Francesco CeiFrancesco Cei More articles by this author , Giacomo MussoGiacomo Musso More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Daniele CignoliDaniele Cignoli More articles by this author , Giuseppe BasileGiuseppe Basile More articles by this author , Gianmarco ColandreaGianmarco Colandrea More articles by this author , Gianfranco BaiamonteGianfranco Baiamonte More articles by this author , Federico BelladelliFederico Belladelli More articles by this author , Isaline RoweIsaline Rowe More articles by this author , Daniela CanibusDaniela Canibus More articles by this author , Chiara ReChiara Re More articles by this author , Roberta LucianòRoberta Lucianò More articles by this author , Maurizio ColecchiaMaurizio Colecchia More articles by this author , Francesco De CobelliFrancesco De Cobelli More articles by this author , Giorgio BrembillaGiorgio Brembilla More articles by this author , Federico DehòFederico Dehò More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Roberto BertiniRoberto Bertini More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , and Umberto CapitanioUmberto Capitanio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002601.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: International guidelines support the use nephrometry scores to measure the anatomical complexity of renal masses and improve clinical decision-making. Since nephrometry scores have been applied to partial nephrectomy (PN) cases only, no formal histologic validation on radical nephrectomy specimen (RN) is available. Our hypothesis states that radiologic characteristics at axial imaging may not be invariably confirmed at final pathology. METHODS: The study population consists of 116 patients treated with RN for cM0 renal cancer. Two expert urologists blinded to final pathology reviewed CT scans and classified each case according to established nephrometry scores (PADUA and SPARE). Concordance rates with final pathological reports were calculated with a specific focus on renal sinus involvement and calyces invasion. Finally, we relied on multivariable logistic regression analyses (LRM) to validate the results. RESULTS: Mean age was 61 years (interquartile range [IQR]: 52-72.7). Mean clinical tumor size was 85 mm. Mean PADUA was 10. The rate of renal sinus involvement was 33% and the concordance rate between radiological score and pathological report was 38%. Rates of over- and underestimation were 53% and 9%, respectively. At LRM, no correlation between nephrometry score and renal sinus involvement was found (OR 0.76, 95 %CI 0.31-1.92; p=0.5). Of 49 patients in whom calyces invasion was evaluated, concordance between radiological imaging and final pathology was recorded in 53% patients. Rates of over- and underestimation were 70% and 30%. Finally, at LRM no correlation between nephrometry score and calyxes invasion was demonstrated (OR 1.52, 95%CI 0.46-5.19; p= 0.4). CONCLUSIONS: At final pathology after RN, anatomical characteristics of nephrometry measured at axial imaging such as sinus involvement and calyces invasion are not confirmed in 1 case out of 2. Specifically, such discordance rate is even higher when evaluating renal sinus involvement (62%) relative to calyxes invasion (47%). Based on this data, caution is urged when PN is excluded preoperatively based nephrometry scores since this indication imply a non-negligible risk of overtreatment. Source of Funding: no © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e687 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Francesco Cei More articles by this author Giacomo Musso More articles by this author Giuseppe Rosiello More articles by this author Giuseppe Fallara More articles by this author Daniele Cignoli More articles by this author Giuseppe Basile More articles by this author Gianmarco Colandrea More articles by this author Gianfranco Baiamonte More articles by this author Federico Belladelli More articles by this author Isaline Rowe More articles by this author Daniela Canibus More articles by this author Chiara Re More articles by this author Roberta Lucianò More articles by this author Maurizio Colecchia More articles by this author Francesco De Cobelli More articles by this author Giorgio Brembilla More articles by this author Federico Dehò More articles by this author Vincenzo Mirone More articles by this author Alberto Briganti More articles by this author Roberto Bertini More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Alessandro Larcher More articles by this author Umberto Capitanio More articles by this author Expand All Advertisement PDF downloadLoading ...