MULTICENTRIC VALIDATION OF PADUA SCORE IN PATIENTS WHO UNDERWENT ROBOTIC PARTIAL NEPHRECTOMY

ULTICENTRIC VALIDATION OF PADUA SCORE IN PATIENTSWHO UNDERWENT ROBOTIC PARTIAL NEPHRECTOMYV. Ficarra*, Padua, Italy; A. Mottrie, Aalst, Belgium; J. Porter,Seattle, WA; N. Buffi, Milan, Italy; P. De Wil, P. Scatteman, Aalst,Belgium; L. Robin, Seattle, WA; L. Tosco, Aalst, Belgium; G. Novara,Padua, Italy; N. Suardi, Aalst, Belgium; A. Cestari, G. Guazzoni,Milan, ItalyINTRODUCTION AND OBJECTIVES: PADUA score has beenproposed in patients who underwent open partial nephrectomy andrecently externally validated in patients treated with open and laparo-scopic partial nephrectomy. The aim of this study was performing anexternal validation of the PADUA score in patients who underwentrobot-assisted partial nephrectomy (RPN).METHODS: Weevaluated retrospectively all the MRI or CTimages of 210patients who underwent RPN for renal tumors in threeCenters between September 2006 and September 2010. In all cases arobotic partial nephrectomy with excision of a rim of healthy peritumorrenal parenchyma has been performed. Tumors were classified accordingto PADUA score in low and intermediate/high risk according the medianscore. The predictive value of the PADUA score has been evaluate usingthe following endpoints: warm ischemia time (WIT), console time (CT),blood loss, percentage of pelicaliceal repair, and overall complications.RESULTS: 117 (55.7%) tumors were located at right side and93 (44.3%) at left side. The mean value of PADUA score was 7.81.5cm (median value was 8). 104 (49.5%) tumors were classified as lowrisk (PADUA score 6–7), 72 (34.3%) as intermediate risk (score 8–9)and 34 (16.2%) as high risk group (score9). PADUA score (low riskversus intermediate/high risk groups) resulted correlated with WIT(p0.001), console time (p0.01), percentage of pelvicaliceal repair(p0.001) and overall complications (p0.001). No correlation wasshown with blood loss (p0.24). WIT higher than 20 min was observedin 81 cases (38.6%). At univariable analysis the following parameterswere correlated with WIT20 minutes: participant center (p0.01);peicaliceal repair (p0.001) and PADUA score (p0.001). PADUAscore (HR 2.410 - p0.007) and pelicaliceal repair (HR 3.355 -p0.001) turned out to be independent predictors of WIT20 minutesin multivariable analysis. PADUA score (p0.001) and pT (p0.01)were also significantly associated with the risk of any complications atunivariable analysis. PADUA score turned out to be the unique inde-pendent predictor of any complications at multivariable analysis (HR:3.226; p0.03) once adjusted for pT.CONCLUSIONS: This multinstitutional study confirmed thatPADUA classification is an effective tool to predict perioperative out-comes in patients who underwent RPN. This classification can beconsidered as an useful tool to improve patients counseling and selec-tion for RPN.