Critical evaluation of the PADUA score in a retrospective analysis of open partial nephrectomy

Several nephrometry scores have been developed to predict postoperative complications in partial nephrectomy based on preoperative imaging characteristics. The most widely used is the PADUA score. We retrospectively evaluated the value of the PADUA score in a consecutive series of open partial nephrectomy in our institution.

Two hundred and thirteen consecutive patients who underwent open partial nephrectomy from January 1, 2012 and December 31, 2016 in our department for suspected renal malignancies were included in the study. The PADUA score was determined from preoperative computed tomography scans and a retrospective analysis of complications and other relevant parameters based on chart review was performed.

Two hundred and thirteen patients underwent open partial nephrectomy, and 72.7% of them had a confirmed renal cell carcinoma (62.9% stage pT1). A total of 73 patients had peri-or postoperative complications (Clavien-Dindo Grades 1-5, n=5, 37, 24, 5 and 0, respectively). Logistic and linear regression analysis did not show any correlation of complications with the preoperative three-group PADUA score. However, the PADUA scores were significantly correlated with operative and ischemia time. Dividing the patients into just two PADUA groups (<8 vs. ≥8 points) did show a significant difference in the severity of complications (OR 5.4, p<0.003).

The PADUA score is an indicator for the complexity of partial nephrectomy and correlates with surgical parameters. Its usefulness in predicting complications is limited.