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- W2058996543 abstract "No AccessJournal of UrologyAdult Urology1 Oct 2011A Multidisciplinary Evaluation of Inter-Reviewer Agreement of the Nephrometry Score and the Prediction of Long-Term Outcomes Christopher J. Weight, Thomas D. Atwell, Robert T. Fazzio, Simon P. Kim, McCabe Kenny, Christine M. Lohse, Stephen A. Boorjian, Bradley C. Leibovich, and R. Houston Thompson Christopher J. WeightChristopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Thomas D. AtwellThomas D. Atwell Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author , Robert T. FazzioRobert T. Fazzio Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author , Simon P. KimSimon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , McCabe KennyMcCabe Kenny Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author , Christine M. LohseChristine M. Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author , Stephen A. BoorjianStephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Bradley C. LeibovichBradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , and R. Houston ThompsonR. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.05.052AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The nephrometry score was introduced in 2009 as a way to quantify renal tumor complexity in a systematic way. However, the reproducibility of scoring has not been rigorously validated across specialty or level of training, nor has it been evaluated with regard to meaningful clinical outcomes. Materials and Methods: We identified 95 consecutive patients with a solid renal mass treated surgically. Each renal tumor was separately scored by 6 reviewers, including 2 staff urologists, 1 staff radiologist, 2 trainees (1 urology, 1 radiology) and 1 medical student. Inter-reviewer agreement for nephrometry score was evaluated using Lin's concordance correlation coefficient. We evaluated the ability of the nephrometry score to predict surgery type, pathological features and clinical outcomes. Results: Agreement in nephrometry score was substantial among the 3 staff physicians (0.72, 95% CI 0.64–0.80). Nephrometry score agreement continued to be substantial when including the trainees and medical student in the analysis (0.75, 95% CI 0.69–0.81). The median nephrometry score of patients treated with radical nephrectomy was 9.0 vs 7.2 for those treated with a nephron sparing approach (p <0.001). Increasing nephrometry score was associated with increased risk of distant metastasis (HR 3.27, p <0.001), death from renal cell carcinoma (HR 2.83, p <0.001) and death from any cause (HR 1.24, p = 0.017). Conclusions: Nephrometry scoring with minimal initial instruction was robust across specialties and levels of training. The additional anatomical information that nephrometry score adds to size alone may be associated with other important clinical outcomes such as tumor aggressiveness and survival, and warrants further study. References 1 : Unintended consequences of laparoscopic surgery on partial nephrectomy for kidney cancer. J Urol2010; 183: 467. Link, Google Scholar 2 : National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization?. Urology2006; 67: 254. 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Link, Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByHeller N, Tejpaul R, Isensee F, Benidir T, Hofmann M, Blake P, Rengal Z, Moore K, Sathianathen N, Kalapara A, Rosenberg J, Chan S, Walczak E, Kutikov A, Uzzo R, Palacios D, Remer E, Campbell S, Papanikolopoulos N and Weight C (2021) Computer-Generated R.E.N.A.L. Nephrometry Scores Yield Comparable Predictive Results to Those of Human-Expert Scores in Predicting Oncologic and Perioperative OutcomesJournal of Urology, VOL. 207, NO. 5, (1105-1115), Online publication date: 1-May-2022.Meyer A, Woldu S, Weinberg A, Thoreson G, Pierorazio P, Matulay J, Benson M, DeCastro G and McKiernan J (2018) Predicting Renal Parenchymal Loss after Nephron Sparing SurgeryJournal of Urology, VOL. 194, NO. 3, (658-663), Online publication date: 1-Sep-2015.Tobert C, Boelkins B, Culver S, Mammen L, Kahnoski R and Lane B (2018) Surgeon Assessment of Renal Preservation with Partial Nephrectomy Provides Information Comparable to Measurement of Volume Preservation with 3-Dimensional Image AnalysisJournal of Urology, VOL. 191, NO. 5, (1218-1224), Online publication date: 1-May-2014.Lane B, Golan S, Eggener S, Tobert C, Kahnoski R, Kutikov A, Smaldone M, Whelan C, Shalhav A and Uzzo R (2018) Differential Use of Partial Nephrectomy for Intermediate and High Complexity Tumors May Explain Variability in Reported Utilization RatesJournal of Urology, VOL. 189, NO. 6, (2047-2053), Online publication date: 1-Jun-2013.Simmons M, Hillyer S, Lee B, Fergany A, Kaouk J and Campbell S (2018) Nephrometry Score is Associated with Volume Loss and Functional Recovery After Partial NephrectomyJournal of Urology, VOL. 188, NO. 1, (39-44), Online publication date: 1-Jul-2012.Simmons M, Hillyer S, Lee B, Fergany A, Kaouk J and Campbell S (2018) Diameter-Axial-Polar Nephrometry: Integration and Optimization of R.E.N.A.L. and Centrality Index Scoring SystemsJournal of Urology, VOL. 188, NO. 2, (384-390), Online publication date: 1-Aug-2012.Okhunov Z, Shapiro E, Moreira D, Lipsky M, Hillelsohn J, Badani K, Landman J and Kavoussi L (2018) R.E.N.A.L. Nephrometry Score Accurately Predicts Complications Following Laparoscopic Renal CryoablationJournal of Urology, VOL. 188, NO. 5, (1796-1800), Online publication date: 1-Nov-2012.Mullins J, Kaouk J, Bhayani S, Rogers C, Stifelman M, Pierorazio P, Tanagho Y, Hillyer S, Kaczmarek B, Chiu Y and Allaf M (2018) Tumor Complexity Predicts Malignant Disease for Small Renal MassesJournal of Urology, VOL. 188, NO. 6, (2072-2076), Online publication date: 1-Dec-2012. Volume 186Issue 4October 2011Page: 1223-1228 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsnephrectomysurvivalradiologycarcinoma, renal cellMetricsAuthor Information Christopher J. Weight Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Thomas D. Atwell Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author Robert T. Fazzio Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author Simon P. Kim Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author McCabe Kenny Department of Radiology, Mayo Clinic, Rochester, Minnesota More articles by this author Christine M. Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author Stephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Bradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author R. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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