Category: Laparoscopic/ Robotic: Other

MP25-19 - Impact of surgical margin status after partial nephrectomy for renal cell carcinoma

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective : The clinical significance of surgical margin status after partial nephrectomy remains controversial.Thus, we analyzed the association between positive surgical margin and risk of cancer recurrence in patients with clinically localized renal cell cancer undergoing partial nephrectomy. Moreover, we evaluated whether a minimal surgical margin less than 1 mm is really safe for cancer control after partial nephrectomy in these patients.


Methods : We retrospectively reviewed the medical records of 855 patients with clinically localized renal cell cancer who underwent partial nephrectomy at our institution between 2005 and 2014. After exclusion of patients who had reported benign pathology and those with incomplete pathological or follow-up data, 748 patients were included in the final analysis. We analyzed data using Kaplan-Meier methods with log-rank tests and multivariate Cox regression models.


Results : Of the 748 patients enrolled in this study, 704 (94.2%) had a negative surgical margin and 44 (5.8%) had a positive surgical margin. Recurrence-free survival for patients with positive surgical margin was significantly lower compared with those with negative surgical margin (p <0.001). When negative surgical margin cases were stratified by the safety margin width (≥1mm vs. <1 mm), there is no significant difference in recurrence-free survival between two groups (p = 0.604). In univariate and multivariate Cox regression analyses, a positive surgical margin was a significant predictor of recurrence (hazard ratio 8.03, 95% confidence interval 2.74–23.56, p <0.001), while the safety margin width <1 mm were not (p = 0.680).


Conclusions : Our study shows that positive surgical margin resulting from partial nephrectomy increases the risk of recurrence in patients with renal cell cancer. Moreover, we demonstrated that only a minimal safety margin of normal tissue of less than 1 mm may be adequate to prevent recurrence. To confirm our findings, large-scale and long-term studies are required.

Hyeok Jun Goh

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Jong Soo Lee

Clinical Fellow
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Won Sik Jang

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

Dong Hoon Koh

Clinical Research Assistant Professor
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea

- Fellowship in department of Urology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Residency in department of Urology, Konyang Univeristy College of Medicine, Daejeon, Korea
- Internship in Konyang Univeristy College of Medicine, Daejeon, Korea

Joo Tae Seo


Seoul, Seoul-t'ukpyolsi, Republic of Korea

In Rae Cho


Ilsan, Kyonggi-do, Republic of Korea

Young Deuk Choi

Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
Seoul, Seoul-t'ukpyolsi, Republic of Korea