The Impact of Recent Scoring Systems on Decision Making for the Treatment of Renal Mass

Abstract

he kidney is a precious organ which deserves special care when dealing with it. Kidney is an organ which is not far away or apart from tumors as the case in the other body organs, making it interesting to study more and more to update the ways of treatment of those tumors. Since 2009, when Kutikov and Uzzo had begun to think about standardization the issue of how to make a proper decision to deal with solid renal tumors and not to leave it to surrender to the surgeon's experiences, when they had settled down RENAL scoring system and till this time many surgeons were being busy trying to standardize the same issue. Being an important issue, our study, hand to hand with the previous studies tried to work hardly to prove, improve and update RENAL nephrometry scoring system, which will help to treat more patients of renal tumors with the right way they deserve to have and to standardize the proper decision of treatment among surgeons all over the world. After months of hard work, during which combined prospective and retrospective studies were applied on thirty seven of the patients with solid renal tumors who had fulfilled the inclusion criteria previously mentioned in the protocol, and after comparing our results with the previous studies' results many issues were concluded. On one hand, Patients with solid renal masses who had low complexity nephrometry scores are more likely to be treated with nephron sparing surgeries and those with high complexity scores are more likely to be treated with radical surgeries. On the other hand, Patients with moderate complexity scores are more candidate for radical interventions. Paradoxically, almost all patients who were included in our study and underwent open nephron sparing surgeries lost more blood during and after the surgeries than those who underwent open radical surgeries. So most probably it's the era of minimally invasive interventions.