The treatment of kidney cancer today is still mainly based on the need for surgery.
When the tumor is small and more easily removed, a partial nephrectomy can be opted for, thus preserving the kidney. However, in the presence of particularly large and anatomically complex lesions, it may be necessary to remove the entire kidney. This decision can be made either before surgery or during the procedure itself, depending on the patient's characteristics and intraoperative circumstances.
How can this choice be predicted?
The objective of our study was to develop a model to objectively estimate the likelihood of completing a partial nephrectomy, compared with a radical nephrectomy, based on various factors such as patient characteristics, anatomical complexity of the tumor, surgeon experience, and the type of surgical approach used.
Our results show that smaller tumors, treated by experienced surgeons and with advanced techniques such as the robotic or open approach, are more likely to be managed with partial nephrectomy.
The developed model demonstrated high predictive accuracy, proving useful for supporting physicians in treatment decisions, clearly explaining options to patients, and better planning surgery.
In summary, we have created a risk calculator that helps accurately predict the likelihood of completing a partial nephrectomy and allows patients to be informed about the risk of needing complete kidney removal.
Francesco Cei 1, Alessandro Larcher 2, Giuseppe Rosiello 3, Giuseppe Basile 1, Giacomo Musso 1, Chiara Re 1, Giuseppe Fallara 3, Federico Belladelli 1, Giorgio Brembilla 4, Giorgia Guazzarotti 5, Francesco De Cobelli 4, Laura Marandino 3, Andrea Necchi 1, Alberto Briganti 1, Andrea Salonia 1, Roberto Bertini 3, Francesco Montorsi 1, Umberto Capitanio 3
- 1Divisionof Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy.
- 2Divisionof Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy. Electronic address: larcher.alessandro@hsr.it.
- 3Divisionof Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy.
- 4UniversityVita-Salute San Raffaele, Milan, Italy; Department of Radiology, IRCCS San Raffaele, Milan, Italy.
- 5Departmentof Radiology, IRCCS San Raffaele, Milan, Italy.
