C-index Score Is Associated With Surgical Management Of T1 Renal Tumor

Objective To investigate the clinical value of C-index score for surgical approach of T1 renal tumors.Methods We retrospectively reviewed the records of 122 patients who underwent surgical treatment for a single tumor,measured and calculated the C-index from preoperative contrast enhanced computerized tomography images.All the date were analyzed to evaluate the relationship between C-index score and surgical approach.Results The cases in low(CI>2.5),moderate(1.6<CI ≤ 2.5)and high(CI ≤ 1.5)complex group were:32,52,38 respectively。The proportion of NSS in each group were:29(90.6%)、33(63.5%).15(39.5%),C-index scoring grade was significantly associated with the surgical approach(χ2=19.53,P<0.01).Significant difference were found in low and moderate,low and high complex group in the surgical approach(P<0.01,P<0.01),Total NSS were 77 cases,including LPN(45)and OPN(32),LPN in low,moderate and high complex group were 21(72.4%)、20(60.6%)、4(26.7%)cases,C-index scoring grade was significantly associated with the surgical approach of NSS(χ2=8.63,P<0.01).Significant difference was found in low and high complex group in surgical approach(P<0.01).In the C-index measurement data,d,x,y values associated with tumor complexity,the correlation coefficients were 0.699,-0.409,-0.392 respectively(P<0.01),in which tumor diameter(d)made the strongest correlation with tumor complexity.Conclusion C-index scoring system can fully describe anatomical features of T1 renal tumors and assess the complexity of the operation。It will make helps for clinicians in how to choose reasonable surgical approach.