SAN DIEGO, CA USA (UroToday.com) - Patterns of intra-operative frozen section analysis (FSA) at the time of renal tumor resection are highly variable and their prognostic utility has increasingly come into question. Drs. Zachary Smith and Thomas Guzzo of the University of Pennsylvania evaluated the relationship of positive surgical margin (PSM) on FSA with surgical, pathological, recurrence and survival outcomes.
The team retrospectively reviewed 370 patients with intra-operative FSA for tumors ranging from < 4 cm (84%), 4-7 cm (13.7%) to > 7 cm (1.9%). Mean follow-up intervals were 30.1 months in the PSM and 26.6 months in the NSM subsets. Twenty-one patients (5.7%) had a PSM on FSA, which correlated significantly with overall risk of recurrence (HR 3.7; CI 1.05-13.2, p=0.042). Recurrence-free survival at 1, 3, and 5 years was statistically different for the two groups (p=0.029), although overall-survival difference at the same intervals did not reach statistical significance (p=0.111).
While published literature generally minimizes the impact of PSM on survival after kidney tumor resection, Dr. Guzzo’s work highlights an important issue, and perhaps with longer follow-up impact on survival may be demonstrated.
Presented by Zachary Smith, Marawan El Tayeb, Phillip Mucksavage, Keith Van Arsdalen, Alan Wein, S. Bruce Malkowicz, and Thomas Guzzo at the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Reported for UroToday.com by Serge Ginzburg, MD
