The impact of nephrometry score on partial nephrectomy rates and survival

Aim: To evaluate the utility of the nephrometry score (NS) and its effects on survival using our experiences with renal tumor data. Materials and methods: Data from 220 patients who underwent renal tumor surgery between 2002 and 2008 were analyzed retrospectively. The exclusion criteria were lack of preoperative tomography films or pathological data and loss of patients for follow-up. Preoperative computed tomography of the patients was evaluated according to the R.E.N.A.L. NS system at www.nephrometry.com, and low, moderate, and high complexity groups were compared. A cut-off point of 8 for the NS was determined and patients were grouped. Kaplan-Meier and logistic regression tests were used for survival analysis. Results: Seventy patients were included in the study. Of these, 49 (70%) were treated with radical nephrectomy and 21 were treated with partial nephrectomy (30%). Low, moderate, and high complexity scores were calculated in 20 (28.5%), 22 (31.4%), and 28 (40%) of the patients, respectively. Partial nephrectomy surgeries comprised 85% (n = 17) of the low complexity group and 18.1% (n = 4) of the moderate group. Univariate analysis showed that pathological stage and complexity group were significant factors indicating survival; pathological stage was the only independent factor. Conclusion: The NS is an objective method in the evaluation of patients with renal tumors and may be a promising means of increasing partial nephrectomy rates in moderately complex cases. Although pathological stage, rather than the NS, is an independent factor for survival, the NS may be a useful preoperative tool.