Parenchymal Volumetric Assessment as a Predictive Tool to Determine Renal Function Benefit of Nephron-Sparing Surgery Compared with Radical Nephrectomy

Michael A Liss, Robert Deconde, Dominique Caovan, Joseph Hofler, Michael Gabe, Kerrin L. Palazzi, Nishant D. Patel, Hak J. Lee, Trey Ideker, Hendrik Van Poppel, David Karow, Michael Aertsen, Giovanna Casola, Ithaar H. Derweesh

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Purpose: To develop a preoperative prediction model using a computer-assisted volumetric assessment of potential spared parenchyma to estimate the probability of chronic kidney disease (CKD, estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) 6 months from extirpative renal surgery (nephron-sparing surgery [NSS] or radical nephrectomy [RN]). Patients and Methods: Retrospective analysis of patients who underwent NSS or RN at our institution from January 2000 to June 2013 with a compatible CT scan 6-month renal function follow-up was performed. Primary outcome was defined as the accuracy of 6-month postoperative eGFR compared with actual postoperative eGFR based on root mean square error (RMSE). Models were constructed using renal volumes and externally validated. A clinical tool was developed on the best model after a given surgical procedure using area under the curve (AUC). Results: We identified 130 (51 radical, 79 partial) patients with a median age of 58 years (interquartile range [IQR] 48-67) and preoperative eGFR of 82.1 (IQR 65.9-104.3); postoperative CKD (eGFR <60) developed in 42% (55/130). We performed various linear regression models to predict postoperative eGFR. The Quadratic model was the highest performing model, which relied only on preoperative GFR and the volumetric data for a RMSE of 15.3 on external validation corresponding to a clinical tool with an AUC of 0.89. Conclusion: Volumetric-based assessment provides information to predict postoperative eGFR. A tool based on this equation may assist surgical counseling regarding renal functional outcomes before renal tumor surgical procedures.

Original languageEnglish (US)
Pages (from-to)114-121
Number of pages8
JournalJournal of Endourology
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2016

    Fingerprint

ASJC Scopus subject areas

  • Urology

Cite this

Liss, M. A., Deconde, R., Caovan, D., Hofler, J., Gabe, M., Palazzi, K. L., Patel, N. D., Lee, H. J., Ideker, T., Van Poppel, H., Karow, D., Aertsen, M., Casola, G., & Derweesh, I. H. (2016). Parenchymal Volumetric Assessment as a Predictive Tool to Determine Renal Function Benefit of Nephron-Sparing Surgery Compared with Radical Nephrectomy. Journal of Endourology, 30(1), 114-121. https://doi.org/10.1089/end.2015.0411