Ján Šulgan, Ján Švihra, Boris Eliáš, Ján Ľupták, Martin Jonáš, Ján Kliment
Objectives: Fuhrman grade (FG) is the most widely used grading system in renal cell carcinoma (RCC) and provides important prognostic value for disease outcome. Nephrometry is novel nomogram focused on Fuhrman grade and mainly for predicting high grade renal cell carcinoma. The study was undertaken to externally validate the prediction nomogram. Material and Methods: The scoring system had 5 components: R (tumour diameter), E (exophytic/endophytic), N (nearness to collecting system), A (anterior/posterior), and L (location in relation to polar lines). We reviewed computed tomography or magnetic resonance imaging scans from 47 patients who underwent partial nephrectomy or radical nephrectomy in the years 2009-2011. Radiologic images were assessed by a urologist, Fuhrman grade was reviewed by two experienced pathologists. Patients were stratified into 4 categories with reference to histopathological grade G1 – G4. Results: 47 patients were integrated into the study. An average age in a cohort was 65.8 years (43 – 88). Of all patients, 29 (61.7 %) were men, 18 (38.3 %) were women. The highest grade G4 was assessed in 11 patients (23.4 %). Clear cell carcinoma was identified in all patients. We confirmed significant correlation 0.559 (p < 0.01) grade vs. RENAL score. The average RENAL score was significantly different as consistent with various Fuhrman grade. The average score increased with reference to accrual of grade in separate categories G1 vs. G2 vs. G3 vs. G4 – 7.7 (SD ± 2.5) vs. 8.6 (SD ± 1.5) vs. 9.5 (SD ± 1.2) vs. 10.8 (SD ± 0.9). Conclusions: Nephrometry RENAL score confirmed predictive value for prognostic risk of clear cell renal cell carcinoma according to Fuhrman grade.