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Background <p>We examined the clinical significance of the distance between the tumor and collecting system or sinus (DTCS), representing the nearness (N) score in the RENAL nephrometry score, on outcomes of robotic-assisted partial nephrectomy (RAPN).</p> Methods <p>We retrospectively analyzed 425 patients who underwent RAPN between 2016 and 2021. Multivariate binary logistic regression was used to assess predictive preoperative clinical factors. Receiver operating characteristic (ROC) curve analysis determined the optimal DTCS cutoff point for each outcome.</p> Results <p>The mean DTCS was 4.0&#xa0;mm (SD 4.6), and 79 were N1, 97 N2, and 249 N3. DTCS was significantly associated with opening of the collecting system (<i>p</i> &lt; 0.001) and trifecta achievement (<i>p</i> = 0.085), but not with pentafecta achievement. Optimal DTCS cutoff values were 4 and 7&#xa0;mm for opening of the collecting system, and 0&#xa0;mm for trifecta achievement.</p> Conclusions <p>While the DTCS cutoff value of 4 and 7&#xa0;mm may indicate surgical technical difficulty, the 0&#xa0;mm appears to be the more clinically relevant cutoff value for perioperative outcome risk stratification.</p>

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Optimal thresholds for the distance between tumor and collecting system predicting collecting system opening and trifecta achievement in RAPN

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Shuhei Yokokawa,
  • Hiroki Ito,
  • Mei Tokumoto,
  • Takayuki Yamamoto,
  • Yasuhiro Numata,
  • Seiichiro Honda,
  • Tomohiko Aigase,
  • Ryosuke Jikuya,
  • Koichi Uemura,
  • Takuya Kondo,
  • Tomoyuki Tatenuma,
  • Yusuke Ito,
  • Mitsuru Komeya,
  • Kentaro Muraoka,
  • Hisashi Hasumi,
  • Kazuhide Makiyama

摘要

Background

We examined the clinical significance of the distance between the tumor and collecting system or sinus (DTCS), representing the nearness (N) score in the RENAL nephrometry score, on outcomes of robotic-assisted partial nephrectomy (RAPN).

Methods

We retrospectively analyzed 425 patients who underwent RAPN between 2016 and 2021. Multivariate binary logistic regression was used to assess predictive preoperative clinical factors. Receiver operating characteristic (ROC) curve analysis determined the optimal DTCS cutoff point for each outcome.

Results

The mean DTCS was 4.0 mm (SD 4.6), and 79 were N1, 97 N2, and 249 N3. DTCS was significantly associated with opening of the collecting system (p < 0.001) and trifecta achievement (p = 0.085), but not with pentafecta achievement. Optimal DTCS cutoff values were 4 and 7 mm for opening of the collecting system, and 0 mm for trifecta achievement.

Conclusions

While the DTCS cutoff value of 4 and 7 mm may indicate surgical technical difficulty, the 0 mm appears to be the more clinically relevant cutoff value for perioperative outcome risk stratification.