Predicting malignant histology in small renal masses: the role of anatomical and radiological nephrometry scores.
5 affiliations
- 1Department of Urology, Kütahya Health Science University, Kütahya, Turkey.
- 2Department of Urology, Kütahya Health Science University, Kütahya, Turkey. [email protected].
- 3Department of Urology, İzmir Bakırçay University, İzmir, Turkey. [email protected].
- 4Department of Radiology, Kütahya Health Science University, Kütahya, Turkey.
- 5Department of Urology, Health Science University, Konya City Hospital, Konya, Turkey.
Abstract
Purpose
To evaluate the ability of anatomical nephrometry scoring systems to predict malignant histology in patients undergoing surgery for small renal masses (SRMs) ≤ 4 cm.Materials and methods
Seventy-two patients with SRMs treated between January 2015 and March 2024 were retrospectively analyzed. Preoperative imaging was used to calculate eight nephrometry scoring systems: RENAL, PADUA, SPARE, DAP, ABC, C-index, NePhRO, Renal Pelvic Score and Zhongshan. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of each scoring system for predicting malignant histology. Associations between nephrometry scores and malignant histology were evaluated using univariable and multivariable logistic regression analyses.Results
Benign pathology was observed in 30.6% of patients. In univariable analyses, PADUA (p = 0.003), RENAL (p = 0.002), SPARE (p = 0.010), DAP (p = 0.012), ABC (p = 0.011), and Zhongshan (p = 0.044) scores were significantly associated with malignant histology. The C-index demonstrated the highest diagnostic performance (AUC = 0.850, p < 0.001). In multivariable analysis, the C-index remained the only independent predictor of malignancy (OR = 0.490, 95% CI 0.246-0.974, p = 0.042). Higher C-index values were associated with benign tumors, whereas lower values were associated with clear-cell renal cell carcinoma.Conclusion
Anatomical nephrometry scores, particularly the C-index, may serve as practical preoperative indicators of tumor biology in SRMs. Incorporating the C-index into clinical evaluation may improve risk stratification and potentially help reduce unnecessary surgical treatment for benign lesions after further validation.
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BibTeX
@article{cetinkaya2026predicting,
title = {{Predicting malignant histology in small renal masses: the role of anatomical and radiological nephrometry scores.}},
author = {Mustafa Baturay Çetinkaya and İbrahim Kartal and Okan Alkış and Şahinde Atlanoğlu and Halil İbrahim İvelik and Şeref Çoşer and Mehmet Sevim and Bekir Aras},
journal = {BMC urology},
year = {2026},
month = aug,
doi = {10.1186/s12894-026-02291-2},
url = {https://europepmc.org/article/MED/42958163},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Predicting malignant histology in small renal masses: the role of anatomical and radiological nephrometry scores.
AU - Mustafa Baturay Çetinkaya
AU - İbrahim Kartal
AU - Okan Alkış
AU - Şahinde Atlanoğlu
AU - Halil İbrahim İvelik
AU - Şeref Çoşer
AU - Mehmet Sevim
AU - Bekir Aras
PY - 2026
DA - 2026/08/03
JO - BMC urology
DO - 10.1186/s12894-026-02291-2
UR - https://europepmc.org/article/MED/42958163
AB - Purpose To evaluate the ability of anatomical nephrometry scoring systems to predict malignant histology in patients undergoing surgery for small renal masses (SRMs) ≤ 4 cm.Materials and methods Seventy-two patients with SRMs treated between January 2015 and March 2024 were retrospectively analyzed. Preoperative imaging was used to calculate eight nephrometry scoring systems: RENAL, PADUA, SPARE, DAP, ABC, C-index, NePhRO, Renal Pelvic Score and Zhongshan. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of each scoring system for predicting malignant histology. Associations between nephrometry scores and malignant histology were evaluated using univariable and multivariable logistic regression analyses.Results Benign pathology was observed in 30.6% of patients. In univariable analyses, PADUA (p = 0.003), RENAL (p = 0.002), SPARE (p = 0.010), DAP (p = 0.012), ABC (p = 0.011), and Zhongshan (p = 0.044) scores were significantly associated with malignant histology. The C-index demonstrated the highest diagnostic performance (AUC = 0.850, p < 0.001). In multivariable analysis, the C-index remained the only independent predictor of malignancy (OR = 0.490, 95% CI 0.246-0.974, p = 0.042). Higher C-index values were associated with benign tumors, whereas lower values were associated with clear-cell renal cell carcinoma.Conclusion Anatomical nephrometry scores, particularly the C-index, may serve as practical preoperative indicators of tumor biology in SRMs. Incorporating the C-index into clinical evaluation may improve risk stratification and potentially help reduce unnecessary surgical treatment for benign lesions after further validation.
SN - 1471-2490
ER -