R.E.N.A.L. (Radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score predicts early tumor recurrence and complications after percutaneous ablative therapies for renal cell carcinoma: a 5-year experience

Journal of Vascular and Interventional Radiology : JVIR
Juan C CamachoHyun S Kim

Abstract

To investigate the prognostic value of R.E.N.A.L. (radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines) nephrometry score after percutaneous ablation of renal cell carcinoma (RCC). A retrospective 5-year study was performed. Participants were 87 consecutive patients (median age, 67.1 y; 59.7% male, 40.3% female) with 101 biopsy-proven RCCs who underwent percutaneous ablation (54.0% cryoablation, 46.0% radiofrequency ablation). Follow-up computed tomography or magnetic resonance imaging was performed in all cases (mean follow-up, 34.6 mo ± 23.5). R.E.N.A.L. scores were analyzed to determine the association of the score with treatment outcomes and complications. All tumors corresponded to stage 1A disease. Mean tumor size was 2.05 cm (range, 0.7-3.9 cm), and 50.5% of the lesions measured > 2 cm. Nephrometry score was > 8 in 31.4% of lesions. Overall recurrence rate was 16.8%, first-year recurrence rate was 7.9%, and complication rate was 9.9%. A nephrometry score > 8 was associated with increased complications after percutaneous ablation (P < .0001), increased overall recurrence (P < .0001), and increased risk of first-year recurrence (P < .0001). Immediat...Continue Reading

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