Purpose To externally validate the Palacios' equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC). Materials and methods Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients' data were used to calculate the predicted NB-GFR through the Palacios' equation: predicted NB-GFR = 35.03 + 0.65 center dot preoperative GFR - 18.19 center dot (if radical nephrectomy) - 0.25 center dot age + 2.83 center dot (if tumor size > 7 cm) - 2.09 center dot (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3-12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Results 2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m(2) (IQR 56.1-90.1) and 64.2 ml/min/1.73 m(2) (IQR 49.6-83); the median predicted NB-GFR was 71.1 ml/min/1.73 m(2) (IQR 58-81.5) and 62.6 ml/min/1.73m(2) (IQR 47.9-75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m(2) in the cohort#1 and #2, respectively. The Palacio's equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m(2) and 35 ml/min/1.73m(2) in cohort#1 and #2. The Lin's concordance correlation coefficient was 0.79 (95% CI 0.77-0.81) and 0.83 (95% CI 0.82-0.85). Conclusions We confirm the predictive performances of Palacios' equation, supporting its utilization in clinical practice.

External validation of the Palacios' equation: a simple and accurate tool to estimate the new baseline renal function after renal cancer surgery

Tafuri, Alessandro;Sandri, Marco;Cerruto, Maria Angela
Supervision
;
Antonelli, Alessandro
2022

Abstract

Purpose To externally validate the Palacios' equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC). Materials and methods Our research group recently published two studies that investigated the association between renal function and cancer-specific survival in RCC. The first one included 3457 patients undergone RN or PN for a cT1-2 RCC coming from five high-volume centers; the second one considered 1767 patients undergone RN or PN for a cT1-4 RCC in a single high-volume center. From such datasets, available complete patients' data were used to calculate the predicted NB-GFR through the Palacios' equation: predicted NB-GFR = 35.03 + 0.65 center dot preoperative GFR - 18.19 center dot (if radical nephrectomy) - 0.25 center dot age + 2.83 center dot (if tumor size > 7 cm) - 2.09 center dot (if diabetes). The observed NB-GFR was calculated by the CKD-EPI equation on serum creatinine at 3-12 months after surgery. Concordance between observed and predicted NB-GFR was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Results 2419 patients were included (1210, cohort #1; 1219, cohort #2). The median observed NB-GFR value in cohorts #1 and #2 was 73.0 ml/min/1.73 m(2) (IQR 56.1-90.1) and 64.2 ml/min/1.73 m(2) (IQR 49.6-83); the median predicted NB-GFR was 71.1 ml/min/1.73 m(2) (IQR 58-81.5) and 62.6 ml/min/1.73m(2) (IQR 47.9-75.9). The concordance line showed a slope of 0.80 and 0.86, and an intercept at 11.02 and 5.41 ml/min/1.73 m(2) in the cohort#1 and #2, respectively. The Palacio's equation moderately over-estimated and under-estimated NB-GFR, for values below and above the cut-off of 50 ml/min/1.73 m(2) and 35 ml/min/1.73m(2) in cohort#1 and #2. The Lin's concordance correlation coefficient was 0.79 (95% CI 0.77-0.81) and 0.83 (95% CI 0.82-0.85). Conclusions We confirm the predictive performances of Palacios' equation, supporting its utilization in clinical practice.
Glomerular filtration rate
Kidney neoplasms
Nephrectomy
New baseline renal function
Renal function decline
Child, Preschool
Creatinine
Glomerular Filtration Rate
Humans
Kidney
Nephrectomy
Retrospective Studies
Kidney Neoplasms
Renal Insufficiency, Chronic
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1078412
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 4
social impact