MARGIN STATUS AFTER PARTIAL NEPHRECTOMY (PN) AND ITS ROLE IN THE RECURRENCE-FREE SURVIVAL (RFS)

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (MP57)1 Apr 2020MP57-18 MARGIN STATUS AFTER PARTIAL NEPHRECTOMY (PN) AND ITS ROLE IN THE RECURRENCE-FREE SURVIVAL (RFS) Cristiano Linck Pazeto*, Petr Macek, Rafael Sanchez-Salas, Breno Amaral, Ahmed S. Zugail, Nathalie Cathala, Annick Mombet, and Marine Lefevre, Xavier Cathelineau Cristiano Linck Pazeto*Cristiano Linck Pazeto* More articles by this author , Petr MacekPetr Macek More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Breno AmaralBreno Amaral More articles by this author , Ahmed S. Zugail, Nathalie Cathala, Annick MombetAhmed S. Zugail, Nathalie Cathala, Annick Mombet More articles by this author , and Marine Lefevre, Xavier CathelineauMarine Lefevre, Xavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000926.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Optimal management of patients with positive surgical margins (PSM) after PN is unclear. Clinical impact of PSM on recurrence/survival are less clear in the literature. We analyzed the impact of PSM status after PN on recurrence-free survival (RFS) and re-treatment-free survival (TFS) METHODS: We analyzed data on patient who underwent RAPN from 2012 and 2019. Two groups were created: positive (PSM) and negative surgical margin (NSM). Only malignant tumors were included. Risk factors for PSM were investigated in a multivariable logistic regression model. To compare the RFS and TFS, log-rank curves were generated. Cox regression was used to adjust potential confounders. RESULTS: Totally 192 patients were analyzed, mean follow-up was 24 m. PSM rate was 10.4% (n=20). No differences between the groups were found in the following variables: age, gender, BMI, side, Charlson Comorbity Index, RENAL score and preoperative eGFR. The median pre-op tumor size was higher in PSM group (42 vs. 30mm; p= 0.006), as well as the postoperative tumor size (36 vs. 30mm; p=0.002). No differences were found in mean warm ischemia time (19 vs. 19min), operation time (138 vs. 122min), estimate blood loss (366 vs. 311ml) and postop stay (5 vs. 5 days); p=NS for all. Tumor distribution was similar among the groups with 65.7 vs. 65%, 18.6% vs. 20% and 11.6% vs. 15% [PSM – NSM] for clear cell, papillary and chromophobe tumors (p=NS), respectively. Higher proportion of pT1b (25 vs. 17%) and pT3 (20 vs. 2.9%) were identified in PSM group (p=0.004). In the multivariable LR, only tumor size predicted the PSM status (OR 1.04; p=0.022). Five (25%) and six (3.4%) patients presented recurrence in PSM and NSM groups, respectively. The RFS was higher in NSM in the log-rank estimative (p<0.001) and after adjusting variables as well (HR 7.2; p=0.004). RFS was not affected by tumor size (p=NS), pT1 subcategories (p=NS) and FUHRMAN G1-2 vs. G3-4 (p=NS). TFS was higher in NSM group (HR 5.6; p=0.016). CONCLUSIONS: The PSM was associated with a lower RFS and TFS. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e869-e869 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cristiano Linck Pazeto* More articles by this author Petr Macek More articles by this author Rafael Sanchez-Salas More articles by this author Breno Amaral More articles by this author Ahmed S. Zugail, Nathalie Cathala, Annick Mombet More articles by this author Marine Lefevre, Xavier Cathelineau More articles by this author Expand All Advertisement PDF downloadLoading ...