To Evaluate The Value Of R.E.N.A.L PADUA And C-index Scoring System In Nephro-sparing Surgery For Patients With Stage T₁ Renal Cell Carcinoma

Objective:To investigate the clinical application of R.E.N.A.L,PADUA,C-index score in patients with stage T1 renal cell carcinoma whom accepted nephron sparing surgery,and to select some parameter which is related to clinical outcomes.Methods:After approved by our institutional review board,we evaluated retrospectively 53 patients who with the stage of T1 underwent NSS between January 2014 to September 2016 in our department,according to the same inclusion,exclusion criteria for the retrospective study.Kruskal-Wallis test analyses were used to assess the relationships between score systems(R.E.N.A.L,PADUA,C-index)and clinical outcomes.Spearman correlation analyses were used to assess the correlation between the items of scoring systems and the clinical outcomes(such as OT,WIT,EBL and so on).After that,to select some parameter which is related to clinical outcomes.Results:Non parametric test(Kruskal-Wallis test)showed no signifficant difference between score systems(R.E.N.A.L Score,PADUA Score,C-index Score)in the application of T1 RCC in patients(P=0.068).Spearman correlation analysis showed,in the R.E.N.A.L score:the correlation between ‘exophytic/endophytic properties' and ‘operation time'(coefficient=0.286,P=0.038)and ‘gastrointestinal recovery time'(Co.=0.298,P=0.030).The correlation between ‘nearness of the tumor to the collecting system or sinus' and ‘operation time'(coefficient=0.661,P<0.001)and ‘estimated blood loss'(coefficient=0.317,P=0.021),and ‘postoperative complications'(coefficient=0.364,P=0.007);The correlation between ‘location relative to the polar lines ' and ‘operation time'(coefficient=0.304,P=0.027).In the PADUA score:the correlation between ‘relationship between tumor and renal sinus' and ‘operation time'(coefficient=0.292,P=0.034)and ‘estimated blood loss'(coefficient=0.301,P=0.029)and ‘creatinine rate'(coefficient=0.292,P=0.034)and ‘indwelling catheter time'(coefficient=0.272,P=0.049);The correlation between ‘Relationship between tumor and collection system' and ‘operation time'(coefficient=0.335,P=0.014);The correlation between ‘exophytic/endophytic properties' and ‘operation time'(coefficient=0.286,P=0.038)and ‘gastrointestinal recovery time'(coefficient=0.298,P=0.030);In the C-index score:the correlation between ‘centrality index'and ‘operation time'(coefficient=0.439,P=0.001).Concluion:1.In the clinical practice,each kind of R.E.N.A.L score,PADUA score,C-index score for patients with the T1 RCC whom underwent the NSS has very important clinical significance;2.Those four parameter(the tumor protruding rate,relationship between tumor and collection system or renal sinus,C-index)of score system is helpful to evaluate patients with the T1 RCC.