Development of a RP scoring system for predicting perioperative outcomes in robot-assisted partial nephrectomy by optimizing RENAL and MAP scores
10.3969/j.issn.1009-8291.2025.01.011
- VernacularTitle:通过优化RENAL和MAP评分构建预测机器人辅助肾部分切除术围手术期结局的RP评分系统
- Author:
Liang ZHENG
1
;
Bohong CHEN
1
;
Haoxiang HUANG
1
;
Cong FENG
1
;
Jin ZENG
1
;
Wei CHEN
1
;
Dapeng WU
1
Author Information
1. Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
- Publication Type:Journal Article
- Keywords:
robot-assisted partial nephrectomy;
RENAL score;
Mayo adhesive probability score;
perioperative outcomes;
tumor size;
perinephric fat thickness
- From:
Journal of Modern Urology
2025;30(1):53-58
- CountryChina
- Language:Chinese
-
Abstract:
[Objective] To establish a new scoring system to predict the perioperative outcomes (operation time, intraoperative blood loss, and trifecta achievement) in patients undergoing robot-assisted partial nephrectomy (RAPN) by integrating the RENAL and Mayo adhesive probability (MAP) scores. [Methods] Clinical data of 178 patients with renal cell carcinoma who underwent RAPN performed by the same surgeon in our hospital during Jan.2015 and Jan.2022 were retrospectively analyzed.The RENAL and MAP scores of all patients were calculated.Linear regression and logistic regression were used to evaluate the associations between the components of the RENAL and MAP scores (a total of 6 variables) and perioperative outcomes.The factors with significant associations were then included into logistic regression analysis to identify independent predictors for constructing an assessment system for perioperative outcomes, and the receiver operating characteristic (ROC) curve was plotted to calculate the area under the curve (AUC) to predict its efficacy. [Results] Multivariate linear regression analysis showed that tumor size (β=6.14, 95%CI: 1.93—10.34, P=0.004), exophytic rate (β=10.60, 95%CI: 3.44—17.76, P=0.004), and perinephric fat thickness (β=16.48, 95%CI: 8.52—24.45, P<0.001) were significantly associated with operation time.Tumor size (β=10.55 95%CI: 5.60—15.49, P<0.001) was associated with both intraoperative blood loss and trifecta achievement (OR=1.73, 95%CI: 1.26—2.36, P=0.001). Multivariate logistic regression analysis of these 3 factors identified tumor size (OR=9.07, 95% CI: 1.18—69.45, P=0.03) and perinephric fat thickness (OR=2.28, 95%CI: 1.86—6.04, P=0.01) as independent predictors of perioperative outcomes.Based on these findings, the tumor size and perinephric fat thickness (RP) scoring was constructed, which demonstrated better predictive ability than RENAL score or MAP score alone (RP vs.RENAL vs.MAP: 0.766 vs.0.548 vs.0.684). [Conclusion] The RP score includes fewer variables than the RENAL and MAP scores but outperforms them.
