Tariq A Khemees1, Elaine T Lam2, Amy S Joehlin-Price3, Amir Mortazavi4, Gary S Phillips5, Ahmad Shabsigh6, David S Sharp6, Debra L Zynger3. 1. Department of Urology, The Ohio State University, Columbus, OH. Electronic address: Tariq.Khemees@osumc.edu. 2. Deparment of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH; Department of Internal Medicine, Division of Medical Oncology, University of Colorado Cancer Center, Aurora, CO. 3. Department of Pathology, The Ohio State University, Columbus, OH. 4. Deparment of Internal Medicine, Division of Medical Oncology, The Ohio State University, Columbus, OH. 5. Center for Biostatistics, The Ohio State University, Columbus, OH. 6. Department of Urology, The Ohio State University, Columbus, OH.
Abstract
OBJECTIVE: To evaluate the viability of glomeruli in the peritumor parenchyma of partial nephrectomy specimens removed for renal cell carcinoma (RCC) and relate it to kidney function, to better understand the contribution of peritumor parenchyma to renal function. MATERIALS AND METHODS: A retrospective analysis of 53 partial nephrectomies containing RCC was performed. Glomeruli within 0.25-cm increments from the tumor were quantified and histologically assessed for viability. Tumor size, minimum and maximum margin size, and pre- and postoperative estimated glomerular filtration rate (eGFR) were obtained. RESULTS: Glomerular viability positively correlated with distance from tumor with mean viable glomeruli in successive 0.25-cm increments of 0-0.25 cm, 58%; 0.25-0.5 cm, 80%; 0.5-0.75 cm, 90%; and 0.75-1.0 cm, 92%. Glomerular viability near the tumor did not correlate with preoperative eGFR, whereas decreased viability further from the tumor did correlate with worse preoperative eGFR. Tumor size showed a nonstatistically significant positive trend with minimum (median 0.15 cm) and maximum margin (median 0.7 cm) sizes. Percent change of glomerular filtration rate did not correlate with margin size (P = .190). CONCLUSION: Renal parenchyma immediately adjacent to RCC contains fewer viable glomeruli compared with the parenchyma further from the tumor. Based on this information, attempts to preserve all non-neoplastic renal parenchyma via a surgical margin approaching zero may not necessarily result in clinically relevant differences in the amount of viable glomeruli remaining or the renal function preserved.
OBJECTIVE: To evaluate the viability of glomeruli in the peritumor parenchyma of partial nephrectomy specimens removed for renal cell carcinoma (RCC) and relate it to kidney function, to better understand the contribution of peritumor parenchyma to renal function. MATERIALS AND METHODS: A retrospective analysis of 53 partial nephrectomies containing RCC was performed. Glomeruli within 0.25-cm increments from the tumor were quantified and histologically assessed for viability. Tumor size, minimum and maximum margin size, and pre- and postoperative estimated glomerular filtration rate (eGFR) were obtained. RESULTS:Glomerular viability positively correlated with distance from tumor with mean viable glomeruli in successive 0.25-cm increments of 0-0.25 cm, 58%; 0.25-0.5 cm, 80%; 0.5-0.75 cm, 90%; and 0.75-1.0 cm, 92%. Glomerular viability near the tumor did not correlate with preoperative eGFR, whereas decreased viability further from the tumor did correlate with worse preoperative eGFR. Tumor size showed a nonstatistically significant positive trend with minimum (median 0.15 cm) and maximum margin (median 0.7 cm) sizes. Percent change of glomerular filtration rate did not correlate with margin size (P = .190). CONCLUSION: Renal parenchyma immediately adjacent to RCC contains fewer viable glomeruli compared with the parenchyma further from the tumor. Based on this information, attempts to preserve all non-neoplastic renal parenchyma via a surgical margin approaching zero may not necessarily result in clinically relevant differences in the amount of viable glomeruli remaining or the renal function preserved.
Authors: Firas G Petros; Michael J Metcalfe; Kai-Jie Yu; Sarp K Keskin; Bryan M Fellman; Courtney M Chang; Cindy Gu; Pheroze Tamboli; Surena F Matin; Jose A Karam; Christopher G Wood Journal: World J Urol Date: 2018-02-27 Impact factor: 4.226
Authors: Behnoush Abedi-Ardekani; Dariush Nasrollahzadeh; Lars Egevad; Rosamonde E Banks; Naveen Vasudev; Ivana Holcatova; Ctibor Povysil; Lenka Foretova; Vladimir Janout; Dana Mates; Viorel Jinga; Amelia Petrescu; Sasa Milosavljevic; Miodrag Ognjanovic; Simona Ognjanovic; Juris Viksna; Anne Y Warren; Mark Lathrop; Yasser Riazalhosseini; Christine Carreira; Estelle Chanudet; James McKay; Paul Brennan; Ghislaine Scélo Journal: Virchows Arch Date: 2021-01-05 Impact factor: 4.064