OBJECTIVES: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1 kidney tumors who underwent NSS. MATERIALS AND METHODS: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1 renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated. The Cox model was used to adjust the tumor size, histological grade, pathological stage, age, surgical margins and type of approach. RESULTS: Overall PSM was 6.3% (n=22). Recurrence was evidenced in 9.1% (n=2) of patients with PSM and 3.5% (n=10) for the group of negative surgical margin (NSM). The estimated local recurrence-free survival rate at 3 years was 96.4% (95% CI 91.9 to 100) for the NSM group and 87.8% (95% CI 71.9 to 100) for PSM group (p=0.02) with no difference in metastasis-free survival. The PSM and pathological high grade (Fuhrman grade III or IV) were independent predictors of local recurrence in the multivariate analysis (HR 12.9, 95%CI 1.8-94, p=0.011 / HR 38.3, 95%CI 3.1-467, p=0.004 respectively). Fuhrman grade proved to be predictor of distant recurrence (HR 8.1, 95%CI 1.6-39.7, p=0.011). CONCLUSIONS: The PSM in pT1 renal tumors showed to have higher risk of local recurrence and thus, worse oncological prognosis. Copyright® by the International Brazilian Journal of Urology.
OBJECTIVES: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1kidney tumors who underwent NSS. MATERIALS AND METHODS: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated. The Cox model was used to adjust the tumor size, histological grade, pathological stage, age, surgical margins and type of approach. RESULTS: Overall PSM was 6.3% (n=22). Recurrence was evidenced in 9.1% (n=2) of patients with PSM and 3.5% (n=10) for the group of negative surgical margin (NSM). The estimated local recurrence-free survival rate at 3 years was 96.4% (95% CI 91.9 to 100) for the NSM group and 87.8% (95% CI 71.9 to 100) for PSM group (p=0.02) with no difference in metastasis-free survival. The PSM and pathological high grade (Fuhrman grade III or IV) were independent predictors of local recurrence in the multivariate analysis (HR 12.9, 95%CI 1.8-94, p=0.011 / HR 38.3, 95%CI 3.1-467, p=0.004 respectively). Fuhrman grade proved to be predictor of distant recurrence (HR 8.1, 95%CI 1.6-39.7, p=0.011). CONCLUSIONS: The PSM in pT1renal tumors showed to have higher risk of local recurrence and thus, worse oncological prognosis. Copyright® by the International Brazilian Journal of Urology.
Authors: A Breda; S V Stepanian; J Liao; J S Lam; G Guazzoni; M Stifelman; K Perry; A Celia; G Breda; P Fornara; S Jackman; A Rosales; J Palou; M Grasso; V Pansadoro; V Disanto; F Porpiglia; C Milani; C Abbou; R Gaston; G Janetschek; N A Soomro; J de la Rosette; M P Laguna; P G Schulam Journal: J Urol Date: 2007-05-11 Impact factor: 7.450
Authors: L Zini; J J Patard; U Capitanio; A Mejean; A Villers; A de La Taille; V Ficarra; M Crepel; R Bertini; L Salomon; G Verhoest; P Perrotte; K Bensalah; P Arjane; J Biserte; F Montorsi; P Karakiewicz Journal: Eur J Surg Oncol Date: 2008-09-04 Impact factor: 4.424
Authors: N Y Piper; J T Bishoff; C Magee; J M Haffron; R C Flanigan; A Mintiens; H P Van Poppel; I M Thompson; W J Harmon Journal: Urology Date: 2001-12 Impact factor: 2.649
Authors: Karim Bensalah; Allan J Pantuck; Nathalie Rioux-Leclercq; Rodolphe Thuret; Francesco Montorsi; Pierre I Karakiewicz; Nicolas Mottet; Laurent Zini; Roberto Bertini; Laurent Salomon; Arnaud Villers; Michel Soulie; Laurent Bellec; Pascal Rischmann; Alexandre De la Taille; Raffi Avakian; Maxime Crepel; Jean-Marie Ferriere; Jean-Christophe Bernhard; Thierry Dujardin; Frédéric Pouliot; Jérôme Rigaud; Christian Pfister; Baptiste Albouy; Laurent Guy; Steven Joniau; Hendrik van Poppel; Thierry Lebret; Thibault Culty; Fabien Saint; Amnon Zisman; Orit Raz; Hervé Lang; Romain Spie; Andreas Wille; Jan Roigas; Alfredo Aguilera; Bastien Rambeaud; Luis Martinez Piñeiro; Ofer Nativ; Roy Farfara; François Richard; Morgan Roupret; Christian Doehn; Patrick J Bastian; Stefan C Muller; Jacques Tostain; Arie S Belldegrun; Jean-Jacques Patard Journal: Eur Urol Date: 2009-03-31 Impact factor: 20.096
Authors: Hiten D Patel; Jeffrey K Mullins; Phillip M Pierorazio; Gautam Jayram; Jason E Cohen; Brian R Matlaga; Mohamad E Allaf Journal: J Urol Date: 2012-10-17 Impact factor: 7.450
Authors: Paras H Shah; Daniel M Moreira; Zhamshid Okhunov; Vinay R Patel; Sameer Chopra; Aria A Razmaria; Manaf Alom; Arvin K George; Oksana Yaskiv; Michael J Schwartz; Mihir Desai; Manish A Vira; Lee Richstone; Jaime Landman; Arieh L Shalhav; Inderbir Gill; Louis R Kavoussi Journal: J Urol Date: 2016-02-19 Impact factor: 7.600
Authors: Michaël M E L Henderickx; Suraj V Baldew; Axel Bex; Patricia J Zondervan; Lorenzo Marconi; Marcel D van Dijk; Faridi S van Etten-Jamaludin; Brunolf W Lagerveld Journal: World J Urol Date: 2022-05-03 Impact factor: 3.661