The oncological impact of positive surgical margins (PSM) after robot-assisted partial nephrectomy (RAPN) is still under debate. We compared PSM and Negative Surgical Margins (NSM) in terms of recurrence-free survival (RFS), metastasis-free survival (MFS) and overall survival (OS) after RAPN, and we identified predictive factors of PSM. Multi-institutional study using the UroCCR database, which prospectively included 2166 RAPN between April 2010 and February 2021 (CNIL DR 2013-206; NCT03293563). Two groups were retrospectively compared: PSM versus NSM. Prognostic factors were assessed using Kaplan-Meyer curves with log-Rank test, cox hazard proportional risk model and logistic regression after univariate comparison. 136 patients had PSM (6.3%) and 2030 (93.7%) had NSM. During a median follow-up of 19 (9-36) months after RAPN, 160 (7.4%) recurrences were reported. Kaplan-Meier curves and analysis suggested that RFS, MFS and OS were not affected by a PSM (p = 0.68; 0.71; 0.88, respectively). In multivariate analysis predictors of PSM were a lower RENAL score (p = 0.001), longer warm ischemia time (WIT) (p = 0.003) and Chromophobe Renal Cell Carcinoma (chrRCC) (p = 0.043). This study found no impact of PSM on RFS, MFS or OS, and predictors of PSM were the RENAL score, WIT and chrRCC.
Scientific reports. 2022 Oct 31*** epublish ***
Arnoult Morrone, Imad Bentellis, Jean-Christophe Bernhard, Karim Bensalah, Cécile Champy, Franck Bruyere, Nicolas Doumerc, Jonathan Olivier, François Audenet, Bastien Parier, Martin Brenier, Jean-Alexandre Long, François-Xavier Nouhaud, Nicolas Branger, Hervé Lang, Thomas Charles, Evanguelos Xylinas, Thibaut Waeckel, Florie Gomez, Romain Boissier, Benjamin Rouget, Aysha Shaikh, Daniel Chevallier, Damien Ambrosetti, Matthieu Durand
Urology, Andrology, Renal Transplant Unit, Hôpital Pasteur 2, Nice University Hospital, Nice, France. ., Urology, Andrology, Renal Transplant Unit, Hôpital Pasteur 2, Nice University Hospital, Nice, France., Department of Urology, Bordeaux University Hospital, Bordeaux, France., Department of Urology, Rennes University Hospital, Rennes, France., Department of Urology, Henri Mondor University Hospital, APHP, Paris, France., Department of Urology, Tours University and Regional Hospital, Tours, France., Department of Urology and Renal Transplantation, Toulouse University Hospital, Toulouse, France., Department of Urology, Lille University and Regional Hospital, Lille, France., Department of Urology, AP-HP Centre, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France., Department of Urology, Hôpital Bicêtre, Université Paris Saclay, APHP, Le Kremlin-Bicêtre, France., Department of Urology, Paris Saint-Joseph Hospital Group, Paris, France., Department of Urology, Grenoble University Hospital, Grenoble, France., Department of Urology, Rouen University Hospital, Rouen, France., Department of Urology, Institut Paoli-Calmettes, Marseille, France., Department of Urology, Strasbourg University and Regional Hospital, Strasbourg, France., Department of Urology, Poitiers University Hospital, Poitiers, France., Department of Urology, Bichat-Claude Bernard Hospital, APHP, Paris Descartes University, Paris, France., Department of Urology, Caen University Hospital, Caen, France., Department of Urology, Tenon Hospital, APHP, Paris, France., Department of Urology and Renal transplantation, La Conception University Hospital, Aix-Marseille University, APHM, Marseille, France., Department of Urology, Libourne Hospital, Libourne, France., Central Laboratory of Pathology, Nice University Hospital, Nice, France.