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                                                                                           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 Questions or
      ‘endophytic,’ ‘exophytic,’ ‘hilar,’ ‘cen-   properties at the deepest location; N     partial nephrectomy.                       com
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