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Assessing the anatomical characteristics of renal masses has a limited effect on the prediction of pathological outcomes in solid, enhancing, small renal masses: results using the PADUA classification system

 Tae Young Shin  ;  Jongchan Kim  ;  Kyo Chul Koo  ;  Sey Kiat Lim  ;  Dong Wook Kim  ;  Min Woong Kang  ;  Koon Ho Rha  ;  Young Deuk Choi  ;  Won Sik Ham 
 BJU INTERNATIONAL, Vol.113(5) : 754-761, 2014 
Journal Title
Issue Date
Age Factors ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Kidney/diagnostic imaging ; Kidney/pathology ; Kidney Diseases/classification ; Kidney Diseases/diagnosis ; Kidney Neoplasms/classification* ; Kidney Neoplasms/diagnosis ; Male ; Middle Aged ; Models, Statistical* ; Neoplasm Staging/methods ; Nomograms ; Predictive Value of Tests ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Sex Factors ; Tomography, X-Ray Computed
anatomy ; carcinoma ; kidney ; pathology ; renal cell
OBJECTIVE: To evaluate whether assessing the anatomical characteristics of renal masses increases the accuracy of prediction of tumour pathology in small renal masses (SRMs). PATIENTS AND METHODS: We retrospectively reviewed 1129 consecutive patients who underwent extirpative surgeries for a clinical T1 renal mass, for which the preoperative aspects and dimensions used for an anatomical (PADUA) classification were available. Multivariate logistic regression analyses of demographic and anatomical characteristics were performed. Nomograms to predict malignancy and high grade pathology were constructed using a basic model (age, sex and tumour size), and an extended model (anatomical characteristics incorporated into the basic model), and the area under the curve (AUC) between models was compared. RESULTS: Age, sex and tumour size were significantly associated with malignancy and high grade pathology in the T1 and T1a category (except sex for high grade pathology in T1a tumours). Exophytic rate (T1 and T1a) and renal sinus or urinary collecting system involvement (only T1a) were also significant predictors of high grade pathology. Nomograms using the extended model for malignancy showed an insignificant AUC increase compared with those using the basic model (T1, from 0.771 to 0.780, P = 0.149, and T1a, from 0.803 to 0.819, P = 0.055). For high grade pathology, the extended model achieved a significant AUC increase (from 0.595 to 0.643, P = 0.014) in the T1a category, but the AUC for both T1 and T1a tumours showed merely modest competence (0.654 and 0.643, respectively). CONCLUSION: Age, sex and tumour size are the primary predictors of tumour pathology of SRMs, and incorporating other anatomical characteristics has only a limited positive effect on the accuracy of prediction of pathological outcomes.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Min Woong(강민웅)
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Kim, Dong Wook(김동욱)
Kim, Jong Chan(김종찬) ORCID logo https://orcid.org/0000-0002-0022-6689
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Lim, Sey Kiat(임세이캣)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
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