Table 3.
– Association between tumor anatomic attributes assessed by Nephrometry score, (a) grade, and (b) tumor histology*
| (a) | ||
|---|---|---|
| Grade | Distribution of high- versus low-grade pathology by NS and components | Direction of association (p value) |
| Nephrometry sum | Low grade: mean 7.69; SD 2.1 | Higher NS associated with higher grade (p < 0.0001) |
| High grade: mean 8.93; SD 1.82 | ||
|
| ||
| Radius (diameter) | Low grade (1: 64.9%, 2: 21.1%, 3: 14.1%) | Higher R associated with higher grade (p < 0.0001) |
| High grade (1: 32.3%, 2: 30.9%, 3: 36.8%) | ||
|
| ||
| Exophytic/endophytic properties | Low grade (1: 42.6%, 2: 43.0%, 3: 14.5%) | None (p = 0.076) |
| High grade (1: 38.8%, 2: 52.2%, 3: 9.0%) | ||
|
| ||
| Nearness of the tumor to the collecting system or sinus | Low grade (1: 25.6%, 2: 7.9%, 3: 66.5%) | Higher N associated with higher grade (p = 0.001) |
| High grade (1: 13.4%, 2: 4.5%, 3: 82.1%) | ||
|
| ||
| Anterior or posterior or X | Low grade (A: 51.9%, P: 34.4%, X: 13.7%) | Higher grade associated with X (p = 0.03) |
| High grade (A: 41.3%, P: 36.8%, X: 21.9%) | ||
|
| ||
| Location relative to the polar lines* | Low grade (1: 34.3%, 2: 24.4%, 3: 41.3%) | Higher L associated with higher grade (p < 0.0001) |
| High grade (1: 11.4%, 2: 27.4%, 3: 61.2%) | ||
|
| ||
| Hilar location (abutting main artery or vein) | Low grade (hilar: 16.9%, nonhilar: 83.1%) | Hilar associated with higher grade (p = 0.013) |
| High grade (hilar: 28.9%, nonhilar: 71.1%) | ||
|
| ||
| (b) | ||
|
| ||
| Tumor histology | Distribution of histologic subtypes by NS and components | Ranking of histologic subtypes by NS and components |
|
| ||
| Nephrometry sum | Clear cell: mean 8.35; SD 1.95 | Papillary < benign < chromophobe < clear cell < other p < 0.0001 |
| Papillary: mean 7.29; SD 2.19 | ||
| Chromophobe: mean 8.37; SD 2.06 | ||
| Other: mean 9.03; SD 2.10 | ||
| Benign: mean 7.64; SD 1.77 | ||
|
| ||
| Radius (diameter) | Clear cell (1: 50.9%, 2: 27.9%, 3: 21.2%) | Benign < papillary < clear cell < chromophobe < other p < 0.0001 |
| Papillary (1: 59.7%, 2: 20.8%, 3: 19.5%) | ||
| Chromophobe (1: 60.0%, 2: 13.3%, 3: 26.7%) | ||
| Other (1: 29.4%, 2: 17.7%, 3: 52.9%) | ||
| Benign (1: 74.1%, 2: 20.7%, 3: 5.2%) | ||
|
| ||
| Exophytic/endophytic properties | Clear cell (1: 35.6%, 2: 52.2%, 3: 12.3%) | Other < papillary < chromophobe < clear cell < benign p = 0.030 |
| Papillary (1: 57.1%, 2: 32.5%, 3: 10.4%) | ||
| Chromophobe (1: 40.0%, 2: 46.7%, 3: 13.3%) | ||
| Other (1: 52.9%, 2: 38.2%, 3: 8.8%) | ||
| Benign (1: 34.5%, 2: 46.5%, 3: 19.0%) | ||
|
| ||
| Nearness of the tumor to the collecting system or sinus | Clear cell (1: 18.1%, 2: 6.8%, 3: 75.2%) | Papillary < benign < clear cell < chromophobe < other p = 0.0007 |
| Papillary (1: 36.4%, 2: 7.8%, 3: 55.9%) | ||
| Chromophobe (1: 16.7%, 2: 0%, 3: 83.3%) | ||
| Other (1: 14.7%, 2: 0%, 3: 85.3%) | ||
| Benign (1: 27.6%, 2: 12.1%, 3: 60.3%) | ||
|
| ||
| Anterior or posterior or X | Clear cell (1: 46.5%, 2: 38.5%, 3: 15.1%) | (No relationship) p = 0.61 |
| Papillary (1: 53.3%, 2: 28.6%, 3: 18.2%) | ||
| Chromophobe (1: 46.7%, 2: 30.0%, 3: 23.3%) | ||
| Other (1: 44.1%, 2: 29.4%, 3: 26.5%) | ||
| Benign (1: 46.6%, 2: 37.9%, 3: 15.5%) | ||
|
| ||
| Location relative to the polar lines* | Clear cell (1: 22.7%, 2: 23.6%, 3: 53.7%) | Papillary < benign < chromophobe < clear cell < other p = 0.005 |
| Papillary (1: 36.4%, 2: 31.2%, 3: 32.5%) | ||
| Chromophobe (1: 20.0%, 2: 30.0%, 3: 50.0%) | ||
| Other (1: 11.8%, 2: 23.5%, 3: 64.7%) | ||
| Benign (1: 22.4%, 2: 39.7%, 3: 37.9%) | ||
|
| ||
| Hilar location (abutting main artery or vein) | Clear cell (hilar: 75.8%, nonhilar: 24.2%) | Benign < papillary < chromophobe < clear cell < other p = 0.0004 |
| Papillary (hilar: 87.0%, nonhilar: 13.0%) | ||
| Chromophobe (hilar: 86.7%, nonhilar: 13.3%) | ||
| Other (hilar: 61.8%, nonhilar: 38.2%) | ||
| Benign (hilar: 93.1%, nonhilar: 6.9%) | ||
A = anterior; E = exophytic/endophytic; L = location; N = nearness; NS = nephrometry sum; P = posterior; R = radius; SD = standard deviation.
*
For each histologic subtype, the ranking was prioritized by the relative contribution of each individual anatomic attribute to overall Nephrometry score. For example, the total N score to the collecting system was statistically lower for papillary tumors than for other histologies, suggesting that papillary tumors less often abut the collecting system. Other refers to sarcomatoid, collecting duct, and other malignant histologic types.