https://doi.org/10.4081/aiua.2024.12496

The association of anatomical renal mass complexity with surgical approach, Hb drop, and the rate of blood transfusion

Vol. 96 No. 3 (2024)
Submitted: March 24, 2024
Accepted: April 6, 2024
Published: October 2, 2024
R.E.N.A.L. Nephrometry Score, Renal Mass Complexity, Surgical Approach, Hemoglobin Drop, Blood Transfusion Prediction
Abstract Views: 134
PDF: 54
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Shakhawan Hama Amin Said
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Lusan Abdulhameed Arkawazi Saiwan
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Mzhda Sahib Jaafar
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Nadhm Kanabi Majeed
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Rawa Bapir
Smart Health Tower, Sulaymaniyah; Department of Urology, Sulaymaniyah Teaching Hospital, Sulaymaniyah; Kscien Organization, Sulaymaniyah, Kurdistan, Iraq.
Ismaeel Aghaways
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Abdullah A. Qadir
College of Medicine, University of Sulaimani, Sulaymaniyah; Smart Health Tower, Sulaymaniyah, Kurdistan, Iraq.
Berun A. Abdalla
https://orcid.org/0000-0001-5638-4128
Smart Health Tower, Sulaymaniyah; Department of Urology, Sulaymaniyah Teaching Hospital, Sulaymaniyah, Kurdistan, Iraq.
Ayoob Asaad Mohammed Abid
College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan, Iraq.
Fahmi H. Kakamad
fahmi.hussein@univsul.edu.iq
College of Medicine, University of Sulaimani, Sulaymaniyah; Smart Health Tower, Sulaymaniyah; Kscien Organization, Sulaymaniyah, Kurdistan, Iraq.

Introduction: The third most prevalent malignant neoplasm involving the urinary tract is renal cell carcinoma (RCC), encompassing nearly 3.5% of the entire cancers afflicting the body. The aim of this research was to explore how the R.E.N.A.L. nephrometry score relates to the decisions made regarding surgery in individuals with localized RCC.
Methods: This prospective study, assessed patients with localized parenchymal renal masses (stages I and II) tentatively diagnosed as RCC. Utilizing preoperative multiphasic renal CT scans and MRI, the R.E.N.A.L. score categorized masses for nephrometry values. Inclusion criteria involved collecting patient data, and data collection utilizing a structured format focusing on the nephrometry grading system.
Results: The study included 64 patients aged (mean ± SD) 49.78 ± 12.35 yrs. Undergoing renal mass surgery, there were 17 (26.5%) low, 28 (43.8%) moderate and 19 (29.7%) high-complexity lesions. All patients with a low Nephrometry score (n = 17) underwent partial nephrectomy, and all cases with a high score (n = 19) underwent radical nephrectomy. For those with a moderate Nephrometry score (n = 28), 13 (46.4%) underwent partial nephrectomy, while the remaining 15 (53.6%) cases underwent radical nephrectomy. Morbidity was low, and no mortality occurred at 180 days. Patients who had lesions fully above or below polar lines were less likely to need blood transfusions. A trend towards higher Fuhrman grades in patients receiving transfusions suggests a potential link between tumor aggressiveness and bleeding risk.
Conclusions: Our findings provide insight on the utilization of the R.E.N.A.L. nephrometry score in forecasting perioperative, post-surgical, and oncological results. Such data might help optimize surgical methods and pre-operative patient counseling.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Shaaban MS, Abou Youssif TM, Mostafa A, et al. Role of RENAL nephrometry scoring system in planning surgical intervention in patients with localized renal masses. Egy J Radiol Nucl Med. 2015;46: 1175-81.
Chow WH, Devesa SS, Warren JL, Fraumeni Jr JF. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281: 1628-31.
Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising Incidence of Small Renal Masses: A Need to Reassess Treatment Effect. J Natl Cancer Inst. 2006;98: 1331–4.
Yousif A, Mohsin SA. malignant renal tumors in Iraq (clinical & epidemiological study). Univ Thi-Qar J Med. 2011;5: 117-26.
Van Poppel H, Da Pozzo L, Albrecht W, et al. A Prospective, Randomised EORTC Intergroup Phase 3 Study Comparing the Oncologic Outcome of Elective Nephron-Sparing Surgery and Radical Nephrectomy for Low-Stage Renal Cell Carcinoma. Eur Urol. 2011; 59: 543–52.
Kunkle DA, Egleston BL, Uzzo RG. Excise, Ablate or Observe: The Small Renal Mass Dilemma—A Meta-Analysis and Review. J Urol. 2008;179: 1227–34.
Kutikov A, Uzzo RG. The RENAL nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. The Journal of urology. 2009;182: 844-53.
Weizer AZ, Gilbert SM, Roberts WW, et al. Tailoring technique of laparoscopic partial nephrectomy to tumor characteristics. J Urol. 2008;180: 1273-8.
Schachter LR, Bach AM, Snyder ME, et al. The impact of tumour location on the histological subtype of renal cortical tumours. BJU int. 2006;98: 63-6.
Venkatesh R, Weld K, Ames CD, et al. Laparoscopic partial nephrectomy for renal masses: effect of tumor location. Urol. 2006;67: 1169-74.
Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56: 786-93.
Simmons MN, Ching CB, Samplaski MK, et al. Kidney tumor location measurement using the C index method. J Urol. 2010;183: 1708-13.
Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56: 786-93.
Hsieh PF, Chang CH, Yang CR, et al. C index is associated with both short-term and long-term renal functional outcome after partial nephrectomy. Urol Sci. 2013;24: 46-50.
Simmons MN, Ching CB, Samplaski MK, et al. Kidney tumor location measurement using the C index method. J Urol. 2010;183:1708-13.
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008. CA J Clin. 2008;58:71-96.
Muhialdeen AS, Ahmed JO, Baba HO, et al. ,Kscien’s List; A New Strategy to Discourage Predatory Journals and Publishers (Second Version). BMJ. 2023;1:24-26.
Parsons JK, Schoenberg MS, Carter HB. Incidental renal tumors: casting doubt on the efficacy of early intervention. Urol. 2001;57: 1013-5.
Hollenbeck BK, Taub DA, Miller DC, et al. National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization?. Urol. 2006; 67:254-9.
Chen DY, Uzzo RG. Optimal management of localized renal cell carcinoma: surgery, ablation, or active surveillance. J Natl Compr Canc Netw. 2009;7: 635-43.
Simhan J, Smaldone MC, Tsai KJ, et al. Objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy. Eur Urol. 2011;60: 724-30.
Novick AC. Guideline for Management of the Clinical Stage1 Renal Mass. AUA Educ Res. 2009, Linthicum, USA. 2009.
Kutikov A, Uzzo RG. The RENAL nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182: 844-53.
Abou Heidar N, Hakam N, El-Asmar JM, et al. The RENAL score’s relevance in determining perioperative and oncological outcomes: a Middle-Eastern tertiary care center experience. Arab J Urol. 2022;20: 115-20.
Canter D, Kutikov A, Manley B, et al. Utility of the RENAL nephrometry scoring system in objectifying treatment decision-making of the enhancing renal mass. Urol. 2011;78: 1089-94.
Sciorio C, Prontera PP, Scuzzarella S, et al. Predictors of surgical outcomes of retroperitoneal laparoscopic partial nephrectomy. Arch Ital Urol Androl. 2020;92.
Bamias A, Escudier B, Sternberg CN, et al. Current clinical practice guidelines for the treatment of renal cell carcinoma: a systematic review and critical evaluation. Oncol. 2017;22: 667-79.
Krabbe LM, Bagrodia A, Margulis V, Wood CG. Surgical management of renal cell carcinoma. Semin Intervent Radiol. 2014;31:27-32.
Osawa T, Hafez KS, Miller DC, et al. Comparison of percutaneous renal mass biopsy and RENAL nephrometry score nomograms for determining benign vs malignant disease and low-risk vs high-risk renal tumors. Urol. 2016;96: 87-92.
Kutikov A, Smaldone MC, Egleston BL, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL Nephrometry score. Eur Urol. 2011;60: 241-8.

How to Cite

Said, S. H. A., Arkawazi Saiwan, L. A., Jaafar, M. S., Majeed, N. K., Bapir, R., Aghaways, I., Qadir, A. A., Abdalla, B. A., Abid, A. A. M., & Kakamad, F. H. (2024). The association of anatomical renal mass complexity with surgical approach, Hb drop, and the rate of blood transfusion. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12496
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.