399 Cancer Recurrence in Positive Margin Partial Nephrectomies: 5-Year Results from the West of Scotland

Abstract

Abstract Aim Provide insight into the incidence of disease recurrence following a positive margin partial nephrectomy in Renal cancer patients. Allowing the analysis of the current surveillance protocols for early detection of disease recurrence. Method A retrospective review of all patients undergoing Partial Nephrectomies (PN) within a single centre between 2016 and 2021 was performed. Demographic data including age and sex, as well as tumour-specific data of histology, RENAL score, tumour margin, surveillance, and disease recurrence was recorded. Follow-up was performed as per WOSCAN guidance. Results 255 patients underwent PN: 79 (31%) open (OPN) and 176 (69%) robotic-assisted procedures (RALPN). OPN was performed in higher risk cancers with a higher risk of positive margin compared to RALPN (10.1% vs 6.25%). The median follow-up time was 35 months. 3 patients with positive margins had recurrence; all were pT3 cancer following OPN of which 2 had metastatic and 1 patient had local recurrence. 18 positive margin patients (95%) were compliant with WOSCAN surveillance guidelines. Conclusions OPN was performed for more complex tumours which had a higher risk of positive margins and thus recurrence. Regional data can be used to better counsel patients, however further work should assess any evolving change in RALPN positive margin rates as more complex tumours are attempted robotically.