MP24-15 POSITIVE SURGICAL MARGINS AFTER ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN): DOES IT REALLY MATTER? (MARGINS STUDY – UroCCR 96)

Abstract

You have accessJournal of UrologyCME1 May 2022MP24-15 POSITIVE SURGICAL MARGINS AFTER ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN): DOES IT REALLY MATTER? (MARGINS STUDY – UroCCR 96) Arnoult Morrone, Imad Bentellis, Jean-Christophe Bernhard, Karim Bensalah, Cécile Champy, Franck Bruyère, Nicolas Doumerc, Olivier Jonathan, François Audenet, Bastien Parier, Martin Brenier, Jean-Alexandre Long, Thomas Charles, Evanguelos Xylinas, Thibaut Waeckel, Florie Gomez, Romain Boissier, Benjamin Rouget, Daniel Chevallier, Damien Ambrosetti, and Matthieu Durand Arnoult MorroneArnoult Morrone More articles by this author , Imad BentellisImad Bentellis More articles by this author , Jean-Christophe BernhardJean-Christophe Bernhard More articles by this author , Karim BensalahKarim Bensalah More articles by this author , Cécile ChampyCécile Champy More articles by this author , Franck BruyèreFranck Bruyère More articles by this author , Nicolas DoumercNicolas Doumerc More articles by this author , Olivier JonathanOlivier Jonathan More articles by this author , François AudenetFrançois Audenet More articles by this author , Bastien ParierBastien Parier More articles by this author , Martin BrenierMartin Brenier More articles by this author , Jean-Alexandre LongJean-Alexandre Long More articles by this author , Thomas CharlesThomas Charles More articles by this author , Evanguelos XylinasEvanguelos Xylinas More articles by this author , Thibaut WaeckelThibaut Waeckel More articles by this author , Florie GomezFlorie Gomez More articles by this author , Romain BoissierRomain Boissier More articles by this author , Benjamin RougetBenjamin Rouget More articles by this author , Daniel ChevallierDaniel Chevallier More articles by this author , Damien AmbrosettiDamien Ambrosetti More articles by this author , and Matthieu DurandMatthieu Durand More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002563.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Oncological impact of positive surgical margins (PSM) after robot-assisted partial nephrectomy (RAPN) is still under debate.We aimed at comparing PSM and Negative Surgical Margins (NSM) in terms of recurrence-free survival (RFS), metastasis-free survival (MFS) and overall survival (OS) after RAPN and to evaluate the risk factors for a PSM to occur. METHODS: We reviewed the charts of 2673 patients in 20 centers who underwent RAPN between April 2010 and February 2021. Two groups were compared: PSM and NSM. Prognostic factors were assessed using, Kaplan-Meyer curves with log-Rank test, cox hazard proportional risk model and logistic regression after univariate comparison. RESULTS: There were 159 patients in the PSM group (5,9%) and 2514 (94,1%) NSM. Median follow-up was 20 (9-38) months after RAPN. Differences were observed for the RENAL score (PSM: 6 vs NSM: 7, p=0,034), the retroperitoneal approach (12.8% vs 6.4% p=0,008), on-clamp procedure (92.4% vs 82.8% p=0,003), warm ischemia time (21.2 vs 18.3, p <0,001) and complications during surgery (7.6% vs 3.8%, p=0,032). Clear-cell Renal Cell Carcinoma (ccRCC) (59.7% vs 69.1%, p=0,018) and Chromophobe Renal Cell Carcinoma (chrRCC) (18.2% vs 9.0%, p <0,001) also showed an association with PSM. Kaplan-Meier curves and analysis suggest that RFS, MFS and OS are not affected by a PSM (respective p=0,21; 0,72; 0,44) (Figure1). In multivariate analysis predictors of PSM were lower RENAL score (p <0,001), warm ischemia time (WIT) (p=0,02) and chrRCC (p=0,02) (Figure 2). CONCLUSIONS: This large prospective multicentric series reported on no impact of PSM on oncological outcomes for patients including RFS, MFS or OS. Moreover, predictors of PSM are the RENAL score, WIT and chrRCC. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e399 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arnoult Morrone More articles by this author Imad Bentellis More articles by this author Jean-Christophe Bernhard More articles by this author Karim Bensalah More articles by this author Cécile Champy More articles by this author Franck Bruyère More articles by this author Nicolas Doumerc More articles by this author Olivier Jonathan More articles by this author François Audenet More articles by this author Bastien Parier More articles by this author Martin Brenier More articles by this author Jean-Alexandre Long More articles by this author Thomas Charles More articles by this author Evanguelos Xylinas More articles by this author Thibaut Waeckel More articles by this author Florie Gomez More articles by this author Romain Boissier More articles by this author Benjamin Rouget More articles by this author Daniel Chevallier More articles by this author Damien Ambrosetti More articles by this author Matthieu Durand More articles by this author Expand All Advertisement PDF downloadLoading ...