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AUA0709.qxp 6/24/09 2:10 PM Page 2 www.renalandurologynews.com JULY 2009 Renal & Urology News 25 n AUA Annual Meeting, Chicago Nephrometry May Improve RCC Care Moreover these descriptive terms are renal mass may be different based The articles on this page and used in concert with highly subjective upon its size and location within the on pages 26 and 40 report patient-, family-, or surgeon-specific kidney, said Dr. Uzzo, Medical on studies presented at the factors when making decisions re- Director for Urology at Renal & American Urological Association garding partial vs. radical nephrec- Urology News. “It may be that tumors Annual Meeting in Chicago. tomy, open vs. minimally invasive with higher nephrometry scores have approaches, and even which patients different pathologies than tumors with are best treated with ablation mo- lower nephrometry scores,” he added. BY JOHN SCHIESZER dalities. This lack of standardization If this is the case, nephrometry could RESEARCHERS HAVE developed makes it difficult to compare treat- aid in establishing a patient’s prog- a standardized scoring system for ment recommendations or the results nosis. The modality’s primary aim, quantifying renal tumor size, loca- of published series.” however, is to standardize the assess- tion, and depth. The new scoring system is based on ment of a lesion’s resectability to help The new tool, called the R.E.N.A.L.- five critical and reproducible anatom- make more meaningful comparisons of Nephrometry Score, could improve ic features of solid renal masses. Four treatment recommendations and the patient management and enable of the components are scored on a literature, Dr. Uzzo pointed out. meaningful comparisons of renal three-point scale, with the fifth com- Robert G. Uzzo, MD Efforts are currently under way to val- masses in clinical practice and in the ponent indicating the anterior or pos- idate the scoring system at other urological literature. terior location of the mass relative to system or sinus; A signals a tumor’s institutions. “The problem is that our literature is the kidney’s coronal plane. anterior/posterior position relative to A detailed explanation of the scoring replete with very qualitative terms to R.E.N.A.L. is an acronym used to the axial midline of the kidney; and L system by Dr. Uzzo and co-author describe how difficult a kidney tumor refer to the components of nephrome- refers to a tumor’s location relative to Alexander Kutikov, MD, also of Fox may be [from a surgical perspective],” try. R refers to radius, a measure of the polar line. Chase, is scheduled to be published said Robert G. Uzzo, MD, Chairman tumor size easily obtained on a picture The nephrometry scores range from in The Journal of Urology. Mean- of the Department of Surgery at Fox archive and communications system as 4 to 12 points; scores of 4-6, 7-9, and while, a description, examples, and Chase Cancer Center in Philadelphia. the maximal diameter of the tumor; E 10-12 translate into low, moderate, an online calculator are available at “Many physicians use terms such as indicates the exophytic/endophytic and high complexity, respectively, for www.nephrometry.com. Questions or ‘endophytic,’ ‘exophytic,’ ‘hilar,’ ‘cen- properties at the deepest location; N partial nephrectomy. com
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