Impact of resection margin status after nephron‐sparing surgery for renal cell carcinoma

• Published in: BJU international 2006-06, Vol.97 (6), p.1208-1210
• Main Authors: BERDJIS, NAVID, HAKENBERG, OLIVER W., ZASTROW, STEFAN, OEHLSCHLÄGER, SVEN, NOVOTNY, VLADIMIR, WIRTH, MANFRED P.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Disease Progression; Follow-Up Studies; Humans; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Kidneys; Medical sciences; Neoplasm Metastasis - pathology; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Nephrectomy - methods; Nephrology. Urinary tract diseases; Nephrons - pathology; Nephrons - surgery; nephron‐sparing surgery; recurrence; renal cell carcinoma; resection margin; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; surgical treatment; Treatment Outcome; Tumors of the urinary system
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2006.06157.x

OBJECTIVE To evaluate whether the negative‐margin width after nephron‐sparing surgery for renal cell carcinoma (RCC) is associated with tumour recurrence. PATIENTS AND METHODS In all, 121 patients had nephron‐sparing surgery for non‐metastatic RCC for elective (85 cases) and imperative (36 cases) indications. Intraoperative frozen sections were routinely obtained and revealed negative margins in all patients. The tumour size and the shortest distance of normal parenchyma around the tumour were assessed. RESULTS After a mean (range) follow‐up of 49.3  (12‐113) months, six patients had disease progression (three with local recurrence, two of whom also had distant metastases and pure metastatic disease in three). The mean (range) width of the negative margins was 0.56 (0.1–2.3) cm. The width of the resection margin did not correlate with disease progression, while tumour size was a strong predictor of progression (P