Back to Search
Start Over
Positive surgical margins are predictors of local recurrence in conservative kidney surgery for pT1 tumors
- Source :
- International Brazilian Journal of Urology, Vol 44, Iss 3, Pp 475-482, International braz j urol, Volume: 44, Issue: 3, Pages: 475-482, Published: JUN 2018, International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology, International braz j urol v.44 n.3 2018, International Braz J Urol, Sociedade Brasileira de Urologia (SBU), instacron:SBU
- Publisher :
- Sociedade Brasileira de Urologia
-
Abstract
- Objectives: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1 kidney tumors who underwent NSS. Materials and Methods: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1 renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated. The Cox model was used to adjust the tumor size, histological grade, pathological stage, age, surgical margins and type of approach. Results: Overall PSM was 6.3% (n=22). Recurrence was evidenced in 9.1% (n=2) of patients with PSM and 3.5% (n=10) for the group of negative surgical margin (NSM). The estimated local recurrence-free survival rate at 3 years was 96.4% (95% CI 91.9 to 100) for the NSM group and 87.8% (95% CI 71.9 to 100) for PSM group (p=0.02) with no difference in metastasis-free survival. The PSM and pathological high grade (Fuhrman grade III or IV) were independent predictors of local recurrence in the multivariate analysis (HR 12.9, 95%CI 1.8-94, p=0.011 / HR 38.3, 95%CI 3.1-467, p=0.004 respectively). Fuhrman grade proved to be predictor of distant recurrence (HR 8.1, 95%CI 1.6-39.7, p=0.011). Conclusions: The PSM in pT1 renal tumors showed to have higher risk of local recurrence and thus, worse oncological prognosis.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Urology
030232 urology & nephrology
Kidney
lcsh:RC870-923
Nephrectomy
Risk Assessment
Disease-Free Survival
Surgical Procedures, Neoplasms
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
medicine
Humans
Clinical significance
Kidney surgery
Stage (cooking)
Survival rate
Pathological
Carcinoma, Renal Cell
Aged
Neoplasm Staging
Retrospective Studies
business.industry
Proportional hazards model
Margins of Excision
Reproducibility of Results
Retrospective cohort study
Middle Aged
Prognosis
lcsh:Diseases of the genitourinary system. Urology
Kidney Neoplasms
Tumor Burden
Treatment Outcome
030220 oncology & carcinogenesis
Female
Original Article
Positive Surgical Margin
Neoplasm Grading
Neoplasm Recurrence, Local
business
Organ Sparing Treatments
Subjects
Details
- Language :
- English
- ISSN :
- 16776119
- Volume :
- 44
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- International Brazilian Journal of Urology
- Accession number :
- edsair.doi.dedup.....463e72b7e2996a88743c892564ad0fa9