Analysis of the RENAL and mRENAL Scores and the Relative Importance of Their Components in the Prediction of Complications and Local Progression after Percutaneous Renal Cryoablation

Samdeep K Mouli, Joseph L. McDevitt*, Yu Kai Su, Ann B Ragin, Yi Gao, Albert A Nemcek Jr, Robert J Lewandowski, Riad Salem, Kent T Sato

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Purpose To determine if modified RENAL (mRENAL) score and its individual components have superior predictive value relative to the RENAL nephrometry score in prediction of complications and recurrence after percutaneous renal cryoablation. Materials and Methods Primary masses treated with CT–guided percutaneous renal cryoablation between June 2007 and May 2016 were retrospectively reviewed. RENAL and mRENAL scores were used to stratify masses into low, medium, and high complexity tertiles. Complications were characterized by SIR criteria. Predictors of complications and local progression were analyzed using multivariate logistic regression and Kaplan-Meier analysis. Results There were 95 renal cryoablation procedures in 86 patients. Of ablations, 89 had at least 1 follow-up imaging study, with median follow-up of 29 months. There were 11 (12.4%) complications, including 5 (6.5%) major complications. Mass complexity, as measured by mRENAL complexity tertile, was associated with increased risk of complications on multivariate analysis (P =.045). Endophytic location was the only individual ordinal component of the RENAL and mRENAL scores associated with complications (P =.021). Local progression occurred in 7 (8.3%) masses. Complexity as measured by either scoring system was not associated with local progression. Only diameter > 3 cm was associated with increased risk of local progression (hazard ratio = 9.9, 95% confidence interval = 2.1–45, P =.003). Conclusions mRENAL score was predictive of complications and tumor size was predictive of recurrence. Use of mRENAL score for complications and tumor size for recurrence should allow for simpler risk stratification and more accurate patient counseling.

Original languageEnglish (US)
Pages (from-to)860-867
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number6
DOIs
StatePublished - Jun 1 2017

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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