Effect of positive surgical margin on survival after partial nephrectomy for renal cell cancer: Long-term results of a single center Böbrek hücreli kanserlerde parsiyel nefrektomi sonrası pozitif cerrahi sınırın sağkalıma etkisi: tek merkezin uzun dönem sonuçları
Journal of Urological Surgery, cilt.7, sa.4, ss.316-324, 2021 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 7 Sayı: 4
- Basım Tarihi: 2021
- Doi Numarası: 10.4274/jus.galenos.2020.0002
- Dergi Adı: Journal of Urological Surgery
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.316-324
- Anahtar Kelimeler: Partial nephrectomy, Positive surgical margin, Survival
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The goal of this study is to evaluate the risk factors that cause positive surgical margin (PSM) after partial nephrectomy (PN) and the effect of PSM on oncological outcomes in a single-centre cohort. Materials and Methods: Patients with PSM (group 1) were identified and contrasted with the negative surgical margin (group 2). Further, the Kaplan-Meier curves and Cox regression models were used to estimate the differences in survival analysis. Results: A total of 302 patients had PN, of which 38 (12.6%) had PSM. In addition, the non-ischaemic procedures in group 1 were higher (p<0.001). Multivariate analysis showed that RENAL nephrometry score (OR: 1.438, p=0.037) and C-index value (OR: 0.224, p=0.012) were important predictive factors for PSM. Moreover, the recurrence rate was 7.9% for group 1 at a median follow-up of 85.2 months and 3.4% for group 2 at a median follow-up of 83.7 months (p=0.181). In a multivariate analysis, the overall survival decreased with co-morbidity index (HR: 1.343, p<0.001) and high tumour stage (HR: 3.886, p=0.003), while cancer-specific survival decreased with mid-renal tumours (HR: 4.157, p=0.007), high tumour stage (HR: 6.274, p=0.017) and recurrence (HR: 5.038, p=0.018). Furthermore, pathological T stage and C-index value were independent risk factors influencing recurrence-free survival. Conclusion: C-index and RENAL nephrometry score are independent risk factors for PSM. Additionally, PSM does not affect the recurrence or survival outcomes.