MP72-18 ONCOLOGICAL OUTCOMES OF POSITIVE SURGICAL MARGINS IN PATIENTS WHO UNDERWENT PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA.

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V1 Apr 2017MP72-18 ONCOLOGICAL OUTCOMES OF POSITIVE SURGICAL MARGINS IN PATIENTS WHO UNDERWENT PARTIAL NEPHRECTOMY FOR RENAL CELL CARCINOMA. Henrique Nonemacher, Mauricio Cordeiro, George Lins de Albuquerque, Joao Brunhara, Paulo Afonso Carvalho, Fabio Gallucci, Leornardo Borges, Rafael Coelho, Vipul Patel, and Willian Nahas Henrique NonemacherHenrique Nonemacher More articles by this author , Mauricio CordeiroMauricio Cordeiro More articles by this author , George Lins de AlbuquerqueGeorge Lins de Albuquerque More articles by this author , Joao BrunharaJoao Brunhara More articles by this author , Paulo Afonso CarvalhoPaulo Afonso Carvalho More articles by this author , Fabio GallucciFabio Gallucci More articles by this author , Leornardo BorgesLeornardo Borges More articles by this author , Rafael CoelhoRafael Coelho More articles by this author , Vipul PatelVipul Patel More articles by this author , and Willian NahasWillian Nahas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2254AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES 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 429 patients cases of non-metastatic renal cell carcinoma who underwent partial nephrectomy (PN) at our institution, from 2001 to 2016. 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 55 (12.8%) patients. Recurrence developed in 26 (6%) patients during a median follow-up of 39 months. A positive margin was associated with an increased risk of relapse on multivariable analysis (HR 3.34, CI95%: 1.24 - 8.10, p= 0.01) Graph 1. In a stratified analysis based on pathological features, a positive surgical margin was significantly associated with a higher risk of recurrence in cases of high risk (Fuhrmann III-IV) (HR 13.8, CI95%: 4.19 - 45.9, p= 0.0005) Graph 2. CONCLUSIONS Positive surgical margins after partial nephrectomy increase the risk of disease recurrence, primarily in patients with high-risk pathological features. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e961-e962 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Henrique Nonemacher More articles by this author Mauricio Cordeiro More articles by this author George Lins de Albuquerque More articles by this author Joao Brunhara More articles by this author Paulo Afonso Carvalho More articles by this author Fabio Gallucci More articles by this author Leornardo Borges More articles by this author Rafael Coelho More articles by this author Vipul Patel More articles by this author Willian Nahas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...