Skip to main content
SpringerLink
Log in
Book cover

Renal Cancer pp 201–209Cite as

Objectifying Complexity of Kidney Cancers: Relationships of Tumor Anatomy and Outcomes

  • Chapter
  • First Online:

  • 1009 Accesses

Abstract

A standardized classification system to communicate relevant attributes of renal tumors did not exist until recently. The emergence and subsequent validation of the RENAL nephrometry score and soon thereafter several other systems have allowed reproducible objectification, reporting, and comparison of salient anatomic features of renal tumors. As such, quantification of anatomic tumor attributes has afforded meaningful correlation of tumor anatomy to surgical, functional, and oncologic outcomes, allowing prognostication of not only perioperative outcomes but also tumor biology. As such, objective and standardized reporting of renal anatomy has now become integral to individualized treatment selection.

This publication was supported in part by grant number P30 CA006927 from the National Cancer Institute and by the Department of Defense, Physician Research Training Award (AK). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute, the National Institutes of Health, nor the Department of Defense. Additional funds were provided by Fox Chase Cancer Center via institutional ­support of the Kidney Cancer Keystone Program.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin. 2012;62(1):10–29.

    Article  PubMed  Google Scholar 

  2. Simard EP, Ward EM, Siegel R, Jemal A. Cancers with increasing incidence trends in the United States: 1999 through 2008. CA Cancer J Clin. 2012;62:118–28.

    Article  Google Scholar 

  3. Parsons JK, Schoenberg MS, Carter HB. Incidental renal tumors: casting doubt on the efficacy of early intervention. Urology. 2001;57(6):1013–5.

    Article  PubMed  CAS  Google Scholar 

  4. Cooperberg MR, Mallin K, Kane CJ, Carroll PR. Treatment trends for stage I renal cell carcinoma. J Urol. 2011;186(2):394–9.

    Article  PubMed  Google Scholar 

  5. Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol. 1969;101(3):297–301.

    PubMed  CAS  Google Scholar 

  6. Volpe A, Cadeddu JA, Cestari A, et al. Contemporary management of small renal masses. Eur Urol. 2011;60(3):501–15.

    Article  PubMed  Google Scholar 

  7. Campbell SC, Novick AC, Belldegrun A, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182(4):1271–9.

    Article  PubMed  Google Scholar 

  8. Ljungberg B, Cowan NC, Hanbury DC, et al. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58(3):398–406.

    Article  PubMed  Google Scholar 

  9. Patel SG, Penson DF, Pabla B, et al. National trends in the use of partial nephrectomy: a rising tide that has not lifted all boats. J Urol. 2012;187(3):816–21.

    Article  PubMed  Google Scholar 

  10. Kunkle DA, Egleston BL, Uzzo RG. Excise, ablate or observe: the small renal mass dilemma-a meta-analysis and review. The Journal of urology. 2008;179(4):1227–33. discussion 1233–1224.

    Article  PubMed  Google Scholar 

  11. Van Poppel H, Da Pozzo L, Albrecht W, et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol. 2011;59(4): 543–52.

    Article  PubMed  Google Scholar 

  12. Chow WH, Devesa SS, Warren JL, Fraumeni Jr JF. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281(17):1628–31.

    Article  PubMed  CAS  Google Scholar 

  13. Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Rising incidence of small renal masses: a need to reassess treatment effect. J Natl Cancer Inst. 2006;98(18):1331–4.

    Article  PubMed  Google Scholar 

  14. Snyder ME, Bach A, Kattan MW, Raj GV, Reuter VE, Russo P. Incidence of benign lesions for clinically localized renal masses smaller than 7 cm in radiological diameter: influence of sex. J Urol. 2006;176(6 Pt 1):2391–2395; discussion 2395–2396.

    Google Scholar 

  15. McKiernan J, Yossepowitch O, Kattan MW, et al. Partial nephrectomy for renal cortical tumors: pathologic findings and impact on outcome. Urology. 2002;60(6):1003–9.

    Article  PubMed  Google Scholar 

  16. Smaldone MC, Kutikov A, Egleston BL, et al. Small renal masses progressing to metastases under active surveillance: a systematic review and pooled analysis. Cancer. 2012;118(4):997–1006.

    Article  PubMed  Google Scholar 

  17. Smaldone MC, Uzzo RG. Active surveillance: a potential strategy for select patients with small renal masses. Future Oncol. 2011;7(10):1133–47.

    Article  PubMed  Google Scholar 

  18. Canter D, Kutikov A, Manley B, et al. Utility of the R.E.N.A.L. nephrometry scoring system in objectifying treatment decision-making of the enhancing renal mass. Urology. 2011;78(5):1089–94.

    Article  PubMed  Google Scholar 

  19. Weight CJ, Crispen PL, Breau RH, et al. Practice-setting and surgeon characteristics heavily influence the decision to perform partial nephrectomy among American urologic association surgeons. BJU Int. 2012. Epub ahead of print

    Google Scholar 

  20. Volpe A, Terrone C. Anatomic classification systems of renal tumors: new, useful tools in renal surgical oncology. Eur Urol. 2011;60(4):731–3.

    Article  PubMed  Google Scholar 

  21. Buechter KJ, Zeppa R, Gomez G. The use of segmental anatomy for an operative classification of liver injuries. Annals of surgery. 1990;211(6):669–73. discussion 673–665.

    Article  PubMed  CAS  Google Scholar 

  22. Couinaud C. Liver anatomy: portal (and suprahepatic) or biliary segmentation. Dig Surg. 1999;16(6): 459–67.

    Article  PubMed  CAS  Google Scholar 

  23. Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844–53.

    Article  PubMed  Google Scholar 

  24. Flocks RH, Kadesky MC. Malignant neoplasms of the kidney; an analysis of 353 patients followed five years or more. J Urol. 1958;79(2):196–201.

    PubMed  CAS  Google Scholar 

  25. Nguyen CT, Campbell SC. Staging of renal cell carcinoma: past, present, and future. Clin Genitourin Cancer. 2006;5(3):190–7.

    Article  PubMed  Google Scholar 

  26. Guinan P, Sobin LH, Algaba F, et al. TNM staging of renal cell carcinoma: workgroup No. 3. Union International Contre le Cancer (UICC) and the American Joint Committee on Cancer (AJCC). Cancer. 1997;80(5):992–993.

    Google Scholar 

  27. Elmore JM, Kadesky KT, Koeneman KS, Sagalowsky AI. Reassessment of the 1997 TNM classification system for renal cell carcinoma. Cancer. 2003;98(11): 2329–34.

    Article  PubMed  Google Scholar 

  28. Patard JJ, Pantuck AJ, Crepel M, et al. Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. Eur Urol. 2007;52(1):148–54.

    Article  PubMed  Google Scholar 

  29. Crispen PL, Boorjian SA, Lohse CM, et al. Outcomes following partial nephrectomy by tumor size. J Urol. 2008;180(5):1912–7.

    Article  PubMed  Google Scholar 

  30. Campbell SC, Novick AC, Streem SB, Klein E, Licht M. Complications of nephron sparing surgery for renal tumors. J Urol. 1994;151(5):1177–80.

    PubMed  CAS  Google Scholar 

  31. Simmons MN, Fergany AF, Campbell SC. Effect of parenchymal volume preservation on kidney function after partial nephrectomy. J Urol. 2011;186(2): 405–10.

    Article  PubMed  Google Scholar 

  32. Lane BR, Russo P, Uzzo RG, et al. Comparison of cold and warm ischemia during partial nephrectomy in 660 solitary kidneys reveals predominant role of nonmodifiable factors in determining ultimate renal function. J Urol. 2011;185(2):421–7.

    Article  PubMed  Google Scholar 

  33. Wright JL, Porter JR. Laparoscopic partial nephrectomy: comparison of transperitoneal and retroperitoneal approaches. J Urol. 2005;174(3):841–5.

    Article  PubMed  Google Scholar 

  34. Ng CS, Gill IS, Ramani AP, et al. Transperitoneal versus retroperitoneal laparoscopic partial nephrectomy: patient selection and perioperative outcomes. J Urol. 2005;174(3):846–9.

    Article  PubMed  Google Scholar 

  35. Porpiglia F, Volpe A, Billia M, Renard J, Scarpa RM. Assessment of risk factors for complications of laparoscopic partial nephrectomy. Eur Urol. 2008;53(3): 590–6.

    Article  PubMed  Google Scholar 

  36. Reisiger K, Venkatesh R, Figenshau RS, Bae KT, Landman J. Complex laparoscopic partial nephrectomy for renal hilar tumors. Urology. 2005;65(5): 888–91.

    Article  PubMed  Google Scholar 

  37. Hruby G, Reisiger K, Venkatesh R, Yan Y, Landman J. Comparison of laparoscopic partial nephrectomy and laparoscopic cryoablation for renal hilar tumors. Urology. 2006;67(1):50–4.

    Article  PubMed  Google Scholar 

  38. Raman JD, Smith B, Messer J, Rohner TJ, Harpster LE, Reese CT. Preoperative predictors of surgical approach for partial nephrectomy. Can J Urol. 2011;18(5):5896–902.

    PubMed  Google Scholar 

  39. Lifshitz DA, Shikanov S, Jeldres C, et al. Laparoscopic partial nephrectomy: predictors of prolonged warm ischemia. J Urol. 2009;182(3):860–5.

    Article  PubMed  Google Scholar 

  40. Kutikov A CP, Uzzo RG. The fox chase R.E.N.A.L. nephrometry score: a comprehensive standardized scoring system for assessing renal tumor size, location and depth. J Urol. 2009;181(suppl 1):354.

    Google Scholar 

  41. Ficarra V, Novara G, Secco S, et al. Preoperative aspects and dimensions used for an anatomical (PADUA) classification of renal tumours in patients who are candidates for nephron-sparing surgery. Eur Urol. 2009;56(5):786–93.

    Article  PubMed  Google Scholar 

  42. http://nephrometry.com/.

  43. Uzzo RG, Cherullo EE, Myles J, Novick AC. Renal cell carcinoma invading the urinary collecting system: implications for staging. J Urol. 2002;167(6):2392–6.

    Article  PubMed  Google Scholar 

  44. Cha EK, Ng CK, Jeun B, et al. Preoperative radiographic parameters predict long-term renal impairment following partial nephrectomy. World j urol. 2011. Epub ahead of print

    Google Scholar 

  45. Simmons MN, Ching CB, Samplaski MK, Park CH, Gill IS. Kidney tumor location measurement using the C index method. J Urol. 2010;183(5):1708–13.

    Article  PubMed  Google Scholar 

  46. Hew MN, Baseskioglu B, Barwari K, et al. Critical appraisal of the PADUA classification and assessment of the R.E.N.A.L. nephrometry score in patients undergoing partial nephrectomy. J Urol. 2011;186(1):42–6.

    Article  PubMed  CAS  Google Scholar 

  47. Kolla SB, Spiess PE, Sexton WJ. Interobserver reliability of the RENAL nephrometry scoring system. Urology. 2011;78(3):592–4.

    Article  PubMed  Google Scholar 

  48. Montag S, Waingankar N, Sadek MA, Rais-Bahrami S, Kavoussi LR, Vira MA, et al. Reproducibility and fidelity of the R.E.N.A.L. nephrometry score. Journal of endourology / Endourological Society. 2011;25(12):1925–8.

    Article  PubMed  Google Scholar 

  49. Okhunov Z, Rais-Bahrami S, George AK, et al. The comparison of three renal tumor scoring systems: C-Index, P.A.D.U.A., and R.E.N.A.L. nephrometry scores. Journal of endourology / Endourological Society. 2011;25(12):1921–4.

    Article  PubMed  Google Scholar 

  50. Weight CJ, Atwell TD, Fazzio RT, et al. A multidisciplinary evaluation of inter-reviewer agreement of the nephrometry score and the prediction of long-term outcomes. J Urol. 2011;186(4):1223–8.

    Article  PubMed  Google Scholar 

  51. Waldert M, Waalkes S, Klatte T, et al. External validation of the preoperative anatomical classification for prediction of complications related to nephron-sparing surgery. World J Urol. 2010;28(4):531–5.

    Article  PubMed  Google Scholar 

  52. Thompson RH, Lane BR, Lohse CM, et al. Every minute counts when the renal hilum is clamped during partial nephrectomy. Eur Urol. 2010;58(3):340–5.

    Article  PubMed  Google Scholar 

  53. Ficarra V, Bhayani S, Porter J, et al. Predictors of warm ischemia time and perioperative complications in a multicenter, international series of robot-assisted partial nephrectomy. Eur Urol. 2012;61(2):395–402.

    Article  PubMed  Google Scholar 

  54. White MA, Haber GP, Autorino R, et al. Outcomes of robotic partial nephrectomy for renal masses with nephrometry score of >/=7. Urology. 2011;77(4):809–13.

    Article  PubMed  Google Scholar 

  55. Samplaski MK, Hernandez A, Gill IS, Simmons MN. C-index is associated with functional outcomes after laparoscopic partial nephrectomy. J Urol. 2010;184(6): 2259–63.

    Article  PubMed  Google Scholar 

  56. Kutikov A, Smaldone MC, Egleston BL, et al. Anatomic features of enhancing renal masses predict malignant and high-grade pathology: a preoperative nomogram using the RENAL nephrometry score. Eur Urol. 2011;60(2):241–8.

    Article  PubMed  Google Scholar 

  57. Simhan J, Smaldone MC, Tsai KJ, et al. Objective measures of renal mass anatomic complexity predict rates of major complications following partial nephrectomy. Eur Urol. 2011;60(4):724–30.

    Article  PubMed  Google Scholar 

  58. Novak R, Mulligan D, Abaza R. Robotic partial nephrectomy without renal ischemia. Urology. 2012;79(6):1296–301.

    Google Scholar 

  59. Gill IS, Kavoussi LR, Lane BR, et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J Urol. 2007;178(1):41–6.

    Article  PubMed  Google Scholar 

  60. Bruner B, Breau RH, Lohse CM, Leibovich BC, Blute ML. Renal nephrometry score is associated with urine leak after partial nephrectomy. BJU Int. 2011;108(1): 67–72.

    Article  PubMed  Google Scholar 

  61. Breau RH, Crispen PL, Jimenez RE, Lohse CM, Blute ML, Leibovich BC. Outcome of stage T2 or greater renal cell cancer treated with partial nephrectomy. J Urol. 2010;183(3):903–8.

    Article  PubMed  Google Scholar 

  62. Wang HK, Zhu Y, Yao XD, et al. External Validation of a nomogram using RENAL nephrometry score to predict high grade renal cell carcinoma. J Urol. 2012;187(5):1555–60.

    Article  PubMed  Google Scholar 

  63. Satasivam P, Sengupta S, Rajarubendra N, Chia PH, Munshey A, Bolton D. Renal lesions with low R.E.N.A.L nephrometry score are associated with more indolent renal cell carcinomas (RCCs) or benign histology: findings in an Australian cohort. BJU Int. 2012;109(3):44–7.

    Article  PubMed  Google Scholar 

  64. Rosevear HM, Gellhaus PT, Lightfoot AJ, Kresowik TP, Joudi FN, Tracy CR. Utility of the RENAL nephrometry scoring system in the real world: predicting surgeon operative preference and complication risk. BJU Int. 2012;109(5):700–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Temple University, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Serge Ginzburg, Alexander Kutikov & Robert G. Uzzo

Authors
  1. Serge Ginzburg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexander Kutikov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert G. Uzzo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert G. Uzzo .

Editor information

Editors and Affiliations

  1. , Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, 01805, Massachusetts, USA

    John A Libertino

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Ginzburg, S., Kutikov, A., Uzzo, R.G. (2013). Objectifying Complexity of Kidney Cancers: Relationships of Tumor Anatomy and Outcomes. In: Libertino, J. (eds) Renal Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7236-0_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7236-0_12

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7235-3

  • Online ISBN: 978-1-4614-7236-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation