PURPOSE - To investigate the impact of positive surgical margins on overall survival in a large American cohort with intermediate-term follow-up.
PATIENTS AND METHODS - Using the National Cancer Data Base, we identified 6,038 cases of pathological T1-T3a, non-metastatic renal cell carcinoma managed with partial nephrectomy from 2003-2006.
Patients were stratified into two groups based on margin status. Predictors of positive margins were evaluated using multivariable logistic regression analysis. Overall survival by margin status was evaluated using Kaplan-Meier analysis and the log rank test. A multivariable Cox proportional hazards model was used to evaluate the adjusted association between margin status and survival.
RESULTS - Overall, 302 (5.3%) patients had positive margins. On multivariable analysis, higher pathological T stage and higher comorbidity score were the only factors significantly associated with positive margins (p
CONCLUSIONS - In the largest observational study to date, positive surgical margins were associated with worse overall survival after partial nephrectomy. Further study into cancer-specific outcomes with long-term follow-up is needed.
Journal of endourology / Endourological Society. 2016 Feb 18 [Epub ahead of print]
Matthew Joseph Maurice, Hui Zhu, Simon P Kim, Robert Abouassaly
Cleveland Clinic, Department of Urology, Glickman Urological & Kidney Institute, Cleveland, Ohio, United States ; Cleveland Clinic, 2569, Department of Urology, Glickman Urological & Kidney Institute, Cleveland, Ohio, United States., UH Case Medical Center, 114516, Urology Institute, Cleveland, Ohio, United States ; UH Case Medical Center, 114516, Urology Institute, Cleveland, Ohio, United States ;