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Published in: World Journal of Urology 7/2023

18-06-2023 | Renal Cancer | Original Article

A three-dimensional renal tumor anatomy and intrarenal relationship nephrometry (ADDD) for robot-assisted partial nephrectomy

3D-CT based nephrometry for RAPN

Authors: Xinfei Li, Dapeng Wu, Xuepei Zhang, Xiang Wang, Yangyang Xu, Shubo Fan, Zhihua Li, Kunlin Yang, Xiaoteng Yu, Zhongyuan Zhang, Lin Cai, Zheng Zhang, Cheng Shen, Jin Tao, Hailong Hu, Liqun Zhou, Xuesong Li

Published in: World Journal of Urology | Issue 7/2023

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Abstract

Objective

To develop a 3D scoring system of tumor anatomy and intrarenal relationship for assessing surgical complexity and outcomes of robot-assisted partial nephrectomy (RAPN).

Methods

We prospectively enrolled patients with a renal tumor who had a 3D model and underwent RAPN between Mar 2019 and Mar 2022. The ADDD nephrometry consisted of the contact surface area between tumor and parenchyma (A), the depth of tumor invasion into the renal parenchyma (D1), the distance from tumor to the main intrarenal artery (D2), and to the collecting system (D3). The primary outcomes included perioperative complication rate and trifecta outcome (WIT ≤ 25 min, negative surgical margins, and no major complications).

Results

We enrolled a total of 301 patients. The mean tumor size was 2.93 ± 1.44 cm. There were 104 (34.6%) patients, 119 (39.5%) patients, and 78 (25.9%) patients in the low-, intermediate-, and high-risk groups, respectively. Each point increase in the ADDD score increased the risk of complications [hazard ratio (HR) 1.501]. A lower grade indicated a lower risk of failed trifecta (HR low group 15.103, intermediate group 9.258) and renal function damage (HR low risk 8.320, intermediate risk 3.165) compared to the high-risk group. The AUC of ADDD score and grade were 0.738 and 0.645 for predicting major complications, 0.766 and 0.714 for predicting trifecta outcome, and 0.746 and 0.730 for predicting postoperative renal function reservation.

Conclusion

The 3D-ADDD scoring system shows the tumor anatomy and its intraparenchymal relationships and has better efficacy in predicting surgical outcomes of RAPN.
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Metadata
Title
A three-dimensional renal tumor anatomy and intrarenal relationship nephrometry (ADDD) for robot-assisted partial nephrectomy
3D-CT based nephrometry for RAPN
Authors
Xinfei Li
Dapeng Wu
Xuepei Zhang
Xiang Wang
Yangyang Xu
Shubo Fan
Zhihua Li
Kunlin Yang
Xiaoteng Yu
Zhongyuan Zhang
Lin Cai
Zheng Zhang
Cheng Shen
Jin Tao
Hailong Hu
Liqun Zhou
Xuesong Li
Publication date
18-06-2023
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 7/2023
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-023-04448-2

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