Pd11-05 Oncological Outcomes of Positive Surgical Margins in Patients Who Underwent Partial Nephrectomy for Renal Cell Carcinoma

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I (PD11)1 May 2024PD11-05 ONCOLOGICAL OUTCOMES OF POSITIVE SURGICAL MARGINS IN PATIENTS WHO UNDERWENT PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA Vinícius Menezes Jesus, Gabriel Carvalho dos Anjos, Guilherme Garcia Barros, David Hamilton Cho, Gabriel Kledeglau Jahchan Alves, Paulo Afonso de Carvalho, Leonardo Cardili, Fabio Pescarmona Galucci, Jose Pontes Junior, Rafael Ferreira Coelho, William Carlos Nahas, and Mauricio Dener Cordeiro Vinícius Menezes JesusVinícius Menezes Jesus , Gabriel Carvalho dos AnjosGabriel Carvalho dos Anjos , Guilherme Garcia BarrosGuilherme Garcia Barros , David Hamilton ChoDavid Hamilton Cho , Gabriel Kledeglau Jahchan AlvesGabriel Kledeglau Jahchan Alves , Paulo Afonso de CarvalhoPaulo Afonso de Carvalho , Leonardo CardiliLeonardo Cardili , Fabio Pescarmona GalucciFabio Pescarmona Galucci , Jose Pontes JuniorJose Pontes Junior , Rafael Ferreira CoelhoRafael Ferreira Coelho , William Carlos NahasWilliam Carlos Nahas , and Mauricio Dener CordeiroMauricio Dener Cordeiro View All Author Informationhttps://doi.org/10.1097/01.JU.0001008604.95535.b9.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The prognostic significance and optimal management of positive surgical margins following partial nephrectomy remain controversial. The association between positive margin and risk of disease recurrence in patients with clinically localized renal neoplasm undergoing partial nephrectomy was evaluated. METHODS: We analyzed the records of 696 patients cases of non-metastatic renal cell carcinoma who underwent partial nephrectomy (PN) at our institution, from 2008 to 2020. Recurrence-free survival was evaluated using Kaplan-Meier method, log rank test and Cox models adjusting for tumor size, grade, histology, pathological stage, focality and laterality. The relationship between positive margin and risk of relapse was evaluated independently for pathological high risk (Fuhrman grades III-IV) and low risk (Fuhrman grades I-II) groups. RESULTS: A positive surgical margin was found in 99 (14,2%) patients. Recurrence developed in 22 (37,3%) patients in the group positive margin and 34 (10,9%) in group negative margin during a median follow-up of 60 months. In the analysis of recurrence in 5 years, we had a significant difference between the Margin groups (p-value=0.0027) Graph 1. We also assessed the extent of the margin with recurrence on a ROC curve, but found no statistically significant difference. In a stratified analysis based on pathological features, a positive surgical margin was significantly associated with a higher risk of local or distance recurrence in cases of high risk (Fuhrmann III-IV) (p-value<0.0001) Graph 2 and 3. CONCLUSIONS: Positive surgical margins after partial nephrectomy increase the risk of disease recurrence, both locally and distantly, primarily in patients with high-risk pathological features. Download PPTDownload PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e250 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Vinícius Menezes Jesus More articles by this author Gabriel Carvalho dos Anjos More articles by this author Guilherme Garcia Barros More articles by this author David Hamilton Cho More articles by this author Gabriel Kledeglau Jahchan Alves More articles by this author Paulo Afonso de Carvalho More articles by this author Leonardo Cardili More articles by this author Fabio Pescarmona Galucci More articles by this author Jose Pontes Junior More articles by this author Rafael Ferreira Coelho More articles by this author William Carlos Nahas More articles by this author Mauricio Dener Cordeiro More articles by this author Expand All Advertisement PDF downloadLoading ...