Nakanishi Yasukazu, Imasato Naoki, Ogasawara Ryo Andy, Hirose Kohei, Sekiya Ken, Katsumura Sao, Kataoka Madoka, Yajima Shugo, Masuda Hitoshi
Department of Urology, National Cancer Center Hospital East, Chiba, Japan.
National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
World J Urol. 2025 Jan 4;43(1):61. doi: 10.1007/s00345-024-05420-4.
To evaluate the association between the newly developed region of interest (ROI)-modified Mayo Adhesive Probability (MAP) score, in which stranding was re-evaluated by computed tomography (CT) number, for predicting operation time in robot-assisted partial nephrectomy (RAPN).
The study participants were 119 patients who underwent transperitoneal RAPN. With regard to stranding, ROIs were evaluated, and the mean CT numbers were assigned a score ranging from 0 to 3. Clinical variables were evaluated in a multivariate logistic regression analysis in relation to prolonged operation time.
The percentage of patients with score ≥ 3 by MAP score alone was significantly higher than those of patients with score ≥ 3 by ROI-modified MAP score alone (26.8% vs. 13.4%, p < 0.001). Multivariate analysis revealed no independent association with the MAP score. On the other hand, for ROI-modified MAP score, score ≥ 3 was an independent factor for prolonged operation time (OR = 4.28, p = 0.0032) along with body mass index (BMI) ≥ 22 (OR = 4.46, p = 0.01), R.E.N.A.L. nephrometry score ≥ 7 (OR = 4.12, p = 0.0047), posterior tumor location (OR = 2.85, p = 0.036), and clinical T stage ≥ 1b (OR = 6.19, p = 0.0044). Regarding the predictive performance, the accuracy of the ROI-modified MAP score was significantly higher than the MAP score (area under the curve [AUC] value: 0.652 vs. 0.721, p = 0.034).
The ROI-modified MAP score was a more relevant factor regarding operation time, suggesting that it might be a better preoperative predictor.
评估新开发的感兴趣区域（ROI）改良梅奥粘连概率（MAP）评分与机器人辅助部分肾切除术（RAPN）手术时间预测之间的关联，该评分通过计算机断层扫描（CT）值对条索状影进行重新评估。
研究参与者为119例行经腹RAPN的患者。对于条索状影，评估ROI，并将平均CT值赋予0至3分。在多因素逻辑回归分析中评估临床变量与手术时间延长的关系。
仅MAP评分≥3分的患者百分比显著高于仅ROI改良MAP评分≥3分的患者（26.8%对13.4%，p<0.001）。多因素分析显示与MAP评分无独立关联。另一方面，对于ROI改良MAP评分，≥3分是手术时间延长的独立因素（OR=4.28，p=0.0032），同时还有体重指数（BMI）≥22（OR=4.46，p=0.01）、R.E.N.A.L.肾计量评分≥7（OR=4.12，p=0.00)、肿瘤位于后侧（OR=2.85，p=0.036）以及临床T分期≥1b（OR=6.19，p=0.0044）。关于预测性能，ROI改良MAP评分的准确性显著高于MAP评分（曲线下面积[AUC]值：0.652对0.721，p=0.034）。
ROI改良MAP评分是与手术时间更相关的因素，表明它可能是更好的术前预测指标。
