Effect of Positive Surgical Margin on Survival After Partial Nephrectomy for Renal Cell Cancer: Long-term Results of a Single Center
Journal Title: Journal of Urological Surgery - Year 2020, Vol 58, Issue 4
Abstract
Objective: The goal of this study is to evaluate the risk factors that cause positive surgical margin (PSM) after partial nephrectomy (PN) and the effect of PSM on oncological outcomes in a single-centre cohort. Materials and Methods: Patients with PSM (group 1) were identified and contrasted with the negative surgical margin (group 2). Further, the Kaplan-Meier curves and Cox regression models were used to estimate the differences in survival analysis. Results: A total of 302 patients had PN, of which 38 (12.6%) had PSM. In addition, the non-ischaemic procedures in group 1 were higher (p<0.001). Multivariate analysis showed that RENAL nephrometry score (OR: 1.438, p=0.037) and C-index value (OR: 0.224, p=0.012) were important predictive factors for PSM. Moreover, the recurrence rate was 7.9% for group 1 at a median follow-up of 85.2 months and 3.4% for group 2 at a median follow-up of 83.7 months (p=0.181). In a multivariate analysis, the overall survival decreased with co-morbidity index (HR: 1.343, p<0.001) and high tumour stage (HR: 3.886, p=0.003), while cancer-specific survival decreased with mid-renal tumours (HR: 4.157, p=0.007), high tumour stage (HR: 6.274, p=0.017) and recurrence (HR: 5.038, p=0.018). Furthermore, pathological T stage and C-index value were independent risk factors influencing recurrence-free survival. Conclusion: C-index and RENAL nephrometry score are independent risk factors for PSM. Additionally, PSM does not affect the recurrence or survival outcomes.
Authors and Affiliations
Mehmet Çağlar Çakıcı, Nihat Karakoyunlu, Alihan Kokurcan, Sercan Sarı, Fatih Sandıkçı, Osman Raif Karabacak, Levent Sağnak, Hikmet Topaloğlu, Hamit Ersoy
Keywords
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- EP ID EP691534
- DOI 10.4274/jus.galenos.2020.0002
- Views 141
- Downloads 0
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