PD11-08 USAGE OF 3D VIRTUAL MODELS TO MAXIMIZE THE ACCURACY OF NEPHROMETRIC SCORES IN DETERMINING THE SURGICAL COMPLEXITY OF RENAL MASSES FIT FOR RAPN: RESULTS FROM A PROSPECTIVE MULTICENTER INTERNATIONAL ERUS VALIDATION STUDY

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11)1 May 2024PD11-08 USAGE OF 3D VIRTUAL MODELS TO MAXIMIZE THE ACCURACY OF NEPHROMETRIC SCORES IN DETERMINING THE SURGICAL COMPLEXITY OF RENAL MASSES FIT FOR RAPN: RESULTS FROM A PROSPECTIVE MULTICENTER INTERNATIONAL ERUS VALIDATION STUDY Daniele Amparore, Enrico Checcucci, Federico Piramide, Paolo Verri, Giuseppe Basile, Alessandro Larcher, Andrea Gaglioli, Angelo Territo, Josep M. Gaya, Pietro Piazza, Stefano Puliatti, Antonio Grosso, Andrea Mari, Riccardo Campi, Laura Zuluaga, Badani Ketan, Sergio Serni, Umberto Capitanio, Francesco Montorsi, Alex Mottrie, Cristian Fiori, Andrea Minervini, Alberto Breda, and Francesco Porpiglia Daniele AmparoreDaniele Amparore , Enrico CheccucciEnrico Checcucci , Federico PiramideFederico Piramide , Paolo VerriPaolo Verri , Giuseppe BasileGiuseppe Basile , Alessandro LarcherAlessandro Larcher , Andrea GaglioliAndrea Gaglioli , Angelo TerritoAngelo Territo , Josep M. GayaJosep M. Gaya , Pietro PiazzaPietro Piazza , Stefano PuliattiStefano Puliatti , Antonio GrossoAntonio Grosso , Andrea MariAndrea Mari , Riccardo CampiRiccardo Campi , Laura ZuluagaLaura Zuluaga , Badani KetanBadani Ketan , Sergio SerniSergio Serni , Umberto CapitanioUmberto Capitanio , Francesco MontorsiFrancesco Montorsi , Alex MottrieAlex Mottrie , Cristian FioriCristian Fiori , Andrea MinerviniAndrea Minervini , Alberto BredaAlberto Breda , and Francesco PorpigliaFrancesco Porpiglia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008604.95535.b9.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 3D virtual models (3DVMs) have been already demonstrated as useful tools to evaluate the anatomical features of the renal masses via nephrometry scores to establish their surgical complexity. Aim of this prospective observational study is to compare the PADUA and RENAL nephrometry scores and relative risk categories (NS/NC) as assessed via 2D imaging and 3DVMs in a large multi-institutional cohort of renal masses suitable for robotic-assisted partial nephrectomy (RAPN), evaluating their predictive role in the occurrence of postoperative complications. METHODS: Six tertiary centers from Europe and US participated the validation study. Patients scheduled for RAPN were prospectively enrolled from 06/2019 to 09/2022, performing a PADUA and RENAL-NSs/NCs assessment with 2D-imaging and 3DVMs. Chi-square test evaluated the different patient's distribution based on the imaging tool used to assess the NSs/NCs, while Cohen's k coefficient tested the concordance between the different classifications. ROC curves have been produced to evaluate sensitivity and specificity of the 3D-NS/NC vs 2D-NS/NCs in predicting the onset of overall postoperative and major complications. Moreover, multivariable logistic analyses were built, looking for predictors of overall and major postoperative complications. RESULTS: A total of 318 patients were included. Both PADUA-NS/NC and RENAL-NS/NC calculated using 3DVMs significantly decreased/were downgraded compared to their 2D counterparts in 43% vs 25% and 49% vs 26% of cases, respectively. PADUA 3D-NS/NC were found to be more accurate than their 2D counterparts in predicting overall postoperative (AUC NS 0.70 vs 0.61; AUC NC 0.71 vs 0.60; p<0.001) and major complications (AUC NS 0.76 vs 0.66; AUC NC 0.76 vs 0.67; p<0.001). Similar results were obtained using the RENAL score to predict overall postoperative complications (AUC NS 0.71 vs 0.59; AUC NC 0.70 vs 0.56; p<0.001) and major complications (AUC NS 0.80 vs 0.58; AUC NC 0.79 vs 0.53; p<0.001). Multivariable analyses confirmed the 3D-PADUA and RENAL NSs/NCs as the only independent predictors of overall (3D-PADUA NS OR: 2.57, p<0.001; 3D-PADUA NC OR: 10.08, p<0.001; 3D-RENAL NS OR: 2.42, p<0.001; 3D-RENAL NC OR: 5.09, p<0.001) and major postoperative complications (3D-PADUA NS OR 2.21, p=0.011; 3D-PADUA NC OR: 10.74, p=0.010; 3D-RENAL NS OR 4.68, p=0.001; 3D-RENAL NC OR 14.10, p<0.001). CONCLUSIONS: In this multi-institutional validation study, 3DVMs have been confirmed to be superior than 2D standard imaging in assessing the PADUA and RENAL nephrometric scores and categories, often reducing the level of surgical complexity but being more accurate in rating with higher scores those cases who are more likely to develop postoperative complications. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e253 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daniele Amparore More articles by this author Enrico Checcucci More articles by this author Federico Piramide More articles by this author Paolo Verri More articles by this author Giuseppe Basile More articles by this author Alessandro Larcher More articles by this author Andrea Gaglioli More articles by this author Angelo Territo More articles by this author Josep M. Gaya More articles by this author Pietro Piazza More articles by this author Stefano Puliatti More articles by this author Antonio Grosso More articles by this author Andrea Mari More articles by this author Riccardo Campi More articles by this author Laura Zuluaga More articles by this author Badani Ketan More articles by this author Sergio Serni More articles by this author Umberto Capitanio More articles by this author Francesco Montorsi More articles by this author Alex Mottrie More articles by this author Cristian Fiori More articles by this author Andrea Minervini More articles by this author Alberto Breda More articles by this author Francesco Porpiglia More articles by this author Expand All Advertisement PDF downloadLoading ...