PADUA score predicts treatment failures in laparoscopic cryoablation of small renal masses

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Objectives To determine the potential of the preoperative aspects and dimensions used for anatomical classification (PADUA) score as a predictive tool in relation to residual unablated tumour and disease-free survival following laparoscopic assisted cryoablation (LCA) of small renal masses. Patients and Methods A multi-institutional cohort of 212 patients with biopsy-verified T1N0M0 renal malignancies treated with LCA between August 2005 and September 2014 were retrospectively investigated with respect to oncological outcomes. Results The preoperative PADUA score was found to be low (6-7 points) in 70 patients (33%), moderate (8-9 points) in 86 patients (40.6%) and high (10-14 points) in 56 patients (26.4%). The mean PADUA score was significantly higher in cases (n=11) with residual unablated tumour (10.4 vs. 8.1, p<0.001) and in cases (n=8) with local tumour recurrence (9.8 vs. 8.1, p<0.001) at a mean follow-up of 37 (95%CI: 34-40) months. The estimated 2, 3 and 5 year disease-free survival for patients with a moderate PADUA score was 96%, 94% and 94% compared to 95%, 87% and 81%, respectively, for patients with a high PADUA score (log-rank, p = 0.003). The PADUA score did not predict overall survival. Conclusion The PADUA score significantly predicts residual unablated tumour and disease-free survival following LCA. Further studies are needed to validate the efficacy of the PADUA score in relation to oncological outcome following ablative procedures.

TidsskriftJournal of Endourology
Sider (fra-til)537-543
StatusUdgivet - 2 feb. 2016

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