MP48-01 PSEUDOCAPSULE INFILTRATION, POSITIVE SURGICAL MARGINS AND LOCAL RECURRENCE AFTER ENUCLEATIVE ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN) FOR RENAL CELL CARCINOMA (RCC): RESULTS AT A MEDIAN FOLLOW-UP OF 56 MONTHS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2018MP48-01 PSEUDOCAPSULE INFILTRATION, POSITIVE SURGICAL MARGINS AND LOCAL RECURRENCE AFTER ENUCLEATIVE ROBOT-ASSISTED PARTIAL NEPHRECTOMY (RAPN) FOR RENAL CELL CARCINOMA (RCC): RESULTS AT A MEDIAN FOLLOW-UP OF 56 MONTHS Riccardo Campi, Fabrizio Di Maida, Andrea Mari, Giulia Bencini, Ilaria Montagnani, Simone Morselli, Andrea Cocci, Alessandro Pili, Alberto Lapini, Marco Carini, Maria Rosaria Raspollini, and Andrea Minervini Riccardo CampiRiccardo Campi More articles by this author , Fabrizio Di MaidaFabrizio Di Maida More articles by this author , Andrea MariAndrea Mari More articles by this author , Giulia BenciniGiulia Bencini More articles by this author , Ilaria MontagnaniIlaria Montagnani More articles by this author , Simone MorselliSimone Morselli More articles by this author , Andrea CocciAndrea Cocci More articles by this author , Alessandro PiliAlessandro Pili More articles by this author , Alberto LapiniAlberto Lapini More articles by this author , Marco CariniMarco Carini More articles by this author , Maria Rosaria RaspolliniMaria Rosaria Raspollini More articles by this author , and Andrea MinerviniAndrea Minervini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1500AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The prognostic role of psecudocapsule (PC) infiltration and positive surgical margins for local recurrence after enucleative RAPN for RCC is still unknown. In this study we report a detailed histopathological analysis of the tumor-parenchymal interface after enucleative RAPN, validating the recently proposed i-Cap (invasion of pseudocapsule) scoring system, and assessing its prognostic value for local recurrence at mid-long term follow-up. METHODS Data from patients undergoing enucleative RAPN at our centre by expert robotic surgeons were prospectively collected from January 2011 to December 2013. A dedicated uropathologist classified the degree of PC infiltration according to our previously reported scheme (PC-, PCK+, PCK++) and retrospectively re-coded it according to the i-Cap scoring system (Figure 1A). Patients with benign tumors and follow-up < 48 months were excluded from the analyses. RESULTS One hundred twenty five patients were included. PC was absent in 3 (2.4%) cases. Histopathological data according to histotypes and i-Cap score system are shown in Figure 1B and 2A, respectively. At multivariable analysis, tumor histotype was the only indipendent predictor of i-Cap score (Figure 2B). Positive surgical margins were recorded in 3 (2.4%) patients. At a median follow up of 56 months (IQR 52-65), 3 cases of local recurrence were detected, all distant from the tumor enucleation bed. CONCLUSIONS In our series, tumor histology and pT stage were the strongest predictors of PC invasion after enucleative RAPN. However, neither PC invasion nor positive margins were associated with local recurrence within the enucleation bed, confirming the oncologic safety of this technique. Further studies are needed to validate our results assessing the prognostic role of PC invasion for different resection techniques. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e624 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Riccardo Campi More articles by this author Fabrizio Di Maida More articles by this author Andrea Mari More articles by this author Giulia Bencini More articles by this author Ilaria Montagnani More articles by this author Simone Morselli More articles by this author Andrea Cocci More articles by this author Alessandro Pili More articles by this author Alberto Lapini More articles by this author Marco Carini More articles by this author Maria Rosaria Raspollini More articles by this author Andrea Minervini More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...