A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery
PurposeComprehension of the anatomical characteristics of pediatric kidney tumors is crucial for making surgical decisions. Previous kidney tumor nephrometry systems failed to incorporate two significant factors: tumor thrombus and multifocality. We develop a refined nephrometry system based on a co...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1501560/full |
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| author | Mingchuan Huang Yingchun Fei Zhihai Zhong Hong Jiang Longshan Liu Juncheng Liu Huanxi Zhang Jun Li Zhe Xu Pengfei Gao Pengfei Gao Changxi Wang Changxi Wang Changxi Wang |
| author_facet | Mingchuan Huang Yingchun Fei Zhihai Zhong Hong Jiang Longshan Liu Juncheng Liu Huanxi Zhang Jun Li Zhe Xu Pengfei Gao Pengfei Gao Changxi Wang Changxi Wang Changxi Wang |
| author_sort | Mingchuan Huang |
| collection | DOAJ |
| description | PurposeComprehension of the anatomical characteristics of pediatric kidney tumors is crucial for making surgical decisions. Previous kidney tumor nephrometry systems failed to incorporate two significant factors: tumor thrombus and multifocality. We develop a refined nephrometry system based on a comprehensive understanding of the characteristics exhibited by pediatric kidney tumors.MethodsThe TUMORS nephrometry scoring system comprises 6 indicators, including tumor (T)hrombus, (U)rinary collecting system involvement, (M)ultiple tumors, (O)utward property, (R)adius, and (S)ite relative to the polar lines. Each renal unit was assessed and scored independently. The complexity characteristics of kidney tumors were summarized, and the correlation was compared with RENAL nephrometry system. Furthermore, the complexity of kidney tumors was compared across different surgical procedures.ResultsA total of 43 patients were enrolled, involving 70 kidney units. Radical nephrectomy (RN) was performed on 13 kidneys, while the remaining 57 kidneys underwent nephron sparing surgery. In the NSS group, tumors in 37 kidneys were resected in vivo, whereas 20 kidneys underwent tumor resection ex vivo followed by kidney autotransplantation. According to the TUMORS nephrometry scoring system, there were 13, 34 and 23 kidney units classified as low, moderate and high complexity, respectively. Tumors that underwent RN or ex vivo removal exhibited higher complexity. The complications and positive margins of NSS were not statistically significant in relation to tumor complexity.ConclusionThe TUMORS nephrometry scoring system holds significant guidance for the decision of surgical protocol and can be applied to the preoperative evaluation. |
| format | Article |
| id | doaj-art-9557c6afd75041ff92e0673a8750b540 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-9557c6afd75041ff92e0673a8750b5402025-01-07T06:40:26ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.15015601501560A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgeryMingchuan Huang0Yingchun Fei1Zhihai Zhong2Hong Jiang3Longshan Liu4Juncheng Liu5Huanxi Zhang6Jun Li7Zhe Xu8Pengfei Gao9Pengfei Gao10Changxi Wang11Changxi Wang12Changxi Wang13Department of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaDepartment of Pediatric Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaOrgan Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaGuangdong Provincial International Cooperation Base of Science and Technology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, ChinaPurposeComprehension of the anatomical characteristics of pediatric kidney tumors is crucial for making surgical decisions. Previous kidney tumor nephrometry systems failed to incorporate two significant factors: tumor thrombus and multifocality. We develop a refined nephrometry system based on a comprehensive understanding of the characteristics exhibited by pediatric kidney tumors.MethodsThe TUMORS nephrometry scoring system comprises 6 indicators, including tumor (T)hrombus, (U)rinary collecting system involvement, (M)ultiple tumors, (O)utward property, (R)adius, and (S)ite relative to the polar lines. Each renal unit was assessed and scored independently. The complexity characteristics of kidney tumors were summarized, and the correlation was compared with RENAL nephrometry system. Furthermore, the complexity of kidney tumors was compared across different surgical procedures.ResultsA total of 43 patients were enrolled, involving 70 kidney units. Radical nephrectomy (RN) was performed on 13 kidneys, while the remaining 57 kidneys underwent nephron sparing surgery. In the NSS group, tumors in 37 kidneys were resected in vivo, whereas 20 kidneys underwent tumor resection ex vivo followed by kidney autotransplantation. According to the TUMORS nephrometry scoring system, there were 13, 34 and 23 kidney units classified as low, moderate and high complexity, respectively. Tumors that underwent RN or ex vivo removal exhibited higher complexity. The complications and positive margins of NSS were not statistically significant in relation to tumor complexity.ConclusionThe TUMORS nephrometry scoring system holds significant guidance for the decision of surgical protocol and can be applied to the preoperative evaluation.https://www.frontiersin.org/articles/10.3389/fped.2024.1501560/fullthrombusnephron sparing surgeryradical nephrectomypediatricWilms tumor |
| spellingShingle | Mingchuan Huang Yingchun Fei Zhihai Zhong Hong Jiang Longshan Liu Juncheng Liu Huanxi Zhang Jun Li Zhe Xu Pengfei Gao Pengfei Gao Changxi Wang Changxi Wang Changxi Wang A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery Frontiers in Pediatrics thrombus nephron sparing surgery radical nephrectomy pediatric Wilms tumor |
| title | A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| title_full | A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| title_fullStr | A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| title_full_unstemmed | A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| title_short | A refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| title_sort | refined kidney tumor nephrometry system employed to screen pediatric patients who are eligible for nephron sparing surgery |
| topic | thrombus nephron sparing surgery radical nephrectomy pediatric Wilms tumor |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1501560/full |
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