Retrospective study of Diameter-axial-polar nephrometry score in predicting high pathological grade of clear cell renal cell carcinoma and papillary renal cell carcinoma

Purpose: To explore whether Diameter-axial-polar nephrometry score has the ability to predict high pathological grade of clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (pRCC). Patients and Methods: We included 430 patients who underwent robotic or laparoscopic partial nephrectomy (PN) or radical nephrectomy (RN) at our center from 1 January, 2021 to 31 March, 2023. Tumor features was recorded using Diameter-axial-polar nephrometry score (DAP score). Logistic regression was performed to analyse the relationship between DAP score and other clinical data with the high pathological grade of ccRCC and pRCC. Results: : In univariate analysis, male (p=0.006), older(p=0.008), BMI≤ 25 kg/m 2 (p=0.036), tumor size (p<0.001). the age-related comorbidity index (ACCI) (p =0.010) and DAP score (p <0.001) was significantly correlated with high pathological grade. Multivariate analysis showed that gender, BMI≤ 25 kg/m 2 and DAP score were independent risk factors of high pathological grade of ccRCC and pRCC. The areas under the curve (AUC) of Multivariate logistic regression was 0.774 (95%CI 0.725-0.823). Conclusion: We confirmed that DAP score is independent risk factor of high pathological grade of ccRCC and pRCC and that a multivariate model incorporating gender and BMI≤ 25 kg/m 2 may help urologist provide treatment recommendations.