Simplified PADUA Renal (SPARE) nephrometry system: French multi-institutional retrospective validation and comparison for Robot-Assisted Partial Nephrectomy (RAPN)

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD12)1 Sep 2021PD12-09 SIMPLIFIED PADUA RENAL (SPARE) NEPHROMETRY SYSTEM: FRENCH MULTI-INSTITUTIONAL RETROSPECTIVE VALIDATION AND COMPARISON FOR ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN) Clément Klein, Clément Michiels, Clément Allenet, Grégoire Capon, Eric Alezra, Vincent Estrade, Franck Bladou, Grégoire Robert, and Jean-Christophe Bernhard Clément Klein Clément Klein More articles by this author , Clément MichielsClément Michiels More articles by this author , Clément AllenetClément Allenet More articles by this author , Grégoire CaponGrégoire Capon More articles by this author , Eric AlezraEric Alezra More articles by this author , Vincent EstradeVincent Estrade More articles by this author , Franck BladouFranck Bladou More articles by this author , Grégoire RobertGrégoire Robert More articles by this author , and Jean-Christophe BernhardJean-Christophe Bernhard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001987.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our objective was to validate and compare the SPARE nephrometry score system (NSs) in a French multi-institutional population. The SPARE NSs is described as easier to implement than the RENAL and PADUA NSs, currently more widely used. METHODS: A retrospective study was conducted using French kidney cancer network (UroCCR) database between May 2010 and October 2020. All patients included in our study had RAPN for cT1-T2 renal tumors. Patients with multiple renal tumors, metastatic disease and patients who received neo- or adjuvant treatment were not included. Surgery success was defined by MIC success (No positive surgical Margins, warm Ischemia time <20 min and No major post-operative Complication (Clavien Dindo ≥3)). The ability of the different NSs to predict MIC achievement was evaluated by uni- and multivariate logistic regression models and areas under the ROC curves. RESULTS: A total of 1829 patients were included. MIC was achieved in 69.2% (n=1266). To predict MIC achievement, all three NSs (RENAL, PADUA and SPARE) were independent predictors in uni- and multivariate analysis (Table 1).Moderate and high RENAL, PADUA and SPARE scores showed a lower rate of MIC achievement with respectively for RENAL score: OR 2.06 (1.62-2.63) and 4.27 (3.13-5.83), for PADUA: OR 1.42 (1.08-1.86) and 3.25 (2.50-4.24) and SPARE: OR 1.98 (1.59-2.46) and 4.10 (2.79-6.06).ROC curves for SPARE, RENAL and PADUA scores are described in figure 1. Respective AUC (CI 95%) were calculated: 0.635, 0.641, 0.645 and no statistically significant difference was observed when comparing the three NSs (RENAL vs PADUA, p=0.8; SPARE vs RENAL, p=0.7 and SPARE vs PADUA, p=0.6). CONCLUSIONS: This study validates the SPARE NSs in a large multi-institutional cohort. It is a simple and reproducible tool offering an equal capacity to predict peri-operatives outcomes as actual NSs recommended (RENAL and PADUA). We think that this simplified score could be introduced in clinical practice to evaluate the feasibility of RAPN. Source of Funding: No © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e206-e206 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Clément Klein More articles by this author Clément Michiels More articles by this author Clément Allenet More articles by this author Grégoire Capon More articles by this author Eric Alezra More articles by this author Vincent Estrade More articles by this author Franck Bladou More articles by this author Grégoire Robert More articles by this author Jean-Christophe Bernhard More articles by this author Expand All Advertisement Loading ...