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Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass

Authors
 Dongkyu An  ;  Dae Chul Jung  ;  Jungwook Lee  ;  Kyunghwa Han  ;  Seungsoo Lee  ;  Ki Don Chang  ;  Koon Ho Rha 
Citation
 INVESTIGATIVE AND CLINICAL UROLOGY, Vol.64(5) : 448-456, 2023-09 
Journal Title
INVESTIGATIVE AND CLINICAL UROLOGY
ISSN
 2466-0493 
Issue Date
2023-09
MeSH
Carcinoma, Renal Cell* / diagnostic imaging ; Carcinoma, Renal Cell* / surgery ; Humans ; Kidney ; Kidney Neoplasms* / diagnostic imaging ; Kidney Neoplasms* / surgery ; Nephrectomy / adverse effects ; Postoperative Complications / etiology
Keywords
Carcinoma, renal cell ; Nephrectomy ; Postoperative complications
Abstract
Purpose: To accurately describe the three-dimensional topology of renal tumors, our study suggests a new nephrometry scoring system, the T-index, that combines information about intraparenchymal extension and peripherality of the renal tumor.

Materials and methods: This study included 113 patients who underwent partial nephrectomy for small clear cell renal cell carcinoma between 2007 and 2014. Manual segmentation of the renal parenchyma, sinus, and tumor was performed using preoperative computed tomography images. The T-index was calculated by adding the reciprocals of the distances from all points on the tumor-parenchyma interface to the renal sinus. Correlations with perioperative factors and the impact of the T-index on postoperative complications were evaluated and compared with existing nephrometry scoring systems (PADUA, RENAL, contact surface area [CSA], and C-index).

Results: The mean value of the T-index among the 113 patients was 116.1±100.5 (1/mm). The T-index showed the strongest correlation with perioperative factors compared with other nephrometry scoring systems. The T-index was able to predict the risk for postoperative complications, either overall (p=0.015) or major complications (p=0.030). A predictive model based on the T-index of the overall postoperative complications presented the best performance (area under the curve, 0.692; 95% CI, 0.599-0.776) compared with other nephrometry scoring systems.

Conclusions: The T-index can be considered as a single value comprising key structural indicators for surgical complexity. Our findings suggest that the T-index can provide a quantitative and objective scoring system associated with surgical difficulty and postoperative complications of partial nephrectomy.
Files in This Item:
T202305540.pdf Download
DOI
10.4111/icu.20230041
Appears in Collections:
1. College of Medicine (의과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Seung Soo(이승수) ORCID logo https://orcid.org/0000-0002-6268-575X
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Han, Kyung Hwa(한경화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196485
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