Prognostic factors for surgical margin status and recurrence in partial nephrectomy

Abstract

Purpose To evaluate the prognostic factors affecting the surgical margin and recurrence in patients who underwent partial nephrectomy (PN) for renal masses. Materials and Methods Data of 125 patients who underwent open or laparoscopic PN because of renal mass between January 2006 and January 2019 were analysed retrospectively. Demographic data, habits, additional diseases, clinical and laboratory findings, operational data, the morphology of the tumour in computerised tomography or magnetic‐resonance imaging and follow‐up data were scanned and acquired via our hospital's system and archive. Results Average age was 54.4, male‐female ratio was 1.55 and average tumour size was 3.31 cm. One hundred and four patients had malignant pathology and 21 were benign. Positive surgical margin (PSM) rate was 5.6% and recurrence rate was 3.2%. Average follow‐up was 47.4 months. Pathological size of the tumour was larger (P = .006), warm‐ischemia period was lower (P = .003) and PADUA score was higher (P = .015) in open technique. Tumour size and tumour stage were statistically higher in patients with recurrence (P = .009, P < .001, respectively). There was a significantly higher PSM ratio in mandatory indication group than elective indication group (P = .025). No statistically significant difference was observed between surgical margin positivity and tumour size, Fuhrman grades, PADUA scores, RENAL scores and C‐index. (P > .05). Conclusion Surgical margin positivity after PN is not significantly associated with tumour characteristics and anatomical scoring systems. Surgical indication for PN has a direct influence on PSM rates. Tumour size and stage after PN are valuable parameters in evaluating the recurrence risk.

The Prognostic Impact of the Surgical Margin in Renal Cell Carcinoma Treated with Partial Nephrectomy: A Multi-Center Study

“…Interestingly, our study did not find a significant association between recurrence and other factors such as age, PADUA score, tumor stage, presence of necrosis, and resection technique. This contrasts with some studies that have suggested these factors may influence recurrence risk [11,25]. The lack of statistical significance in our study could be due to sample size or the distribution of these factors within our cohort.…”

“…The Leibovich score, tumor size, and Fuhrmann grade, among other factors, were also significantly associated with recurrence in our study. This is in agreement with previous studies that have validated the Leibovich scoring system as a reliable predictor of recurrence in RCC [11][12][13].…”

Complication Rates and Postoperative Renal Function in Partial Nephrectomy- Which Factors Should be Considered?

“…Even though this study has one of the longest follow-up span in the literature, low number of cases can be asserted as the main limitation of this study. This study also has the feature of being supplementary to our recent study about the prognostic factors indicating surgical margin status and recurrence in partial nephrectomy patients [29]. The number of patients have increased throughout the years, enriching this study.…”