R.E.N.A.L score - a tool for surgical planning: Retrospective study.

Introduction: This study aims to demonstrate the proportion of partial and total nephrectomy based on preoperative staging of the R.E.N.A.L score in a 7-year from a single institution. Materials and methods: Cohort study, the nephrometry score were available in 56 patients in our retrospective renal mass surgical database from 2017 to 2023. The R.E.N.A.L. score was analyzed both in its sum and its individual component scores according to the treatment approach. Results: 56 medical records were included, according to graduation R.E.N.A.L. 14.3%, 53.6% and 32.1% were of low, moderate and high complexity, respectively. 53.6% were treated with partial nephrectomy. About 71% of the masses were clear cell carcinomas. The “R” and “L” components proved to be greater predictors of radical conduct as well as the higher the sum of this score (p<0.05). The mean R.E.N.A.L. score of the group treated with partial and total nephrectomies were: 7.40 ± 1.43 and 9.54 ± 1.39 (p<0.05). Those undergoing partial nephrectomy showed margin compromise in 37.5% of low complexities and 42% of moderate complexity. Conclusion: In this study, in cases of moderate complexity, individual assessment proved to be essential, so that it was possible to perform partial nephrectomy in almost half of the cases, with a very slight increase in margin compromise in relation to low complexity tumors, from 37.5% to 42%. The R.E.N.A.L score alone did not prove to be a superior tool in deciding on surgical procedures in relation to individual analysis based on the surgeon's experience.