RENAL nephrometry score predicts postoperative recurrence of localized renal cell carcinoma treated by radical nephrectomy

We investigated the association between the R.E.N.A.L. nephrometry score (RNS) and the postoperative recurrence of localized renal cell carcinoma (RCC). We retrospectively analyzed a database comprising 91 patients with non-small localized RCC (pT1b-T2b) treated by radical nephrectomy at our hospital from January 2002 to March 2010. RNS was scored based on imaging findings at diagnosis. The Cox proportional hazards model was used to predict recurrence-free survival (RFS) and to calculate hazard ratio (HR). The median age at operation was 63 years (range, 30-85 years). Postoperative recurrence occurred in 19 patients (21 %). Median RNS sum was 9 (range, 5-11). High RNS sum (10-12) was significantly associated with RFS (P = 0.0012). Multivariate analysis revealed that high RNS sum [HR, 9.05; 95 % confidence interval (CI), 2.11-63.9; P = 0.0019] were significantly associated with RFS. Regarding each component of RNS, only the L component, which referred to tumor location relative to the polar line, was associated with RFS (HR, 15.0; 95 % CI, 2.68-396; P = 0.0006). RNS was associated with RFS in cases of non-small localized RCC (pT1b-2b), thus supporting its utility as a prognostic factor.