To examine the incidence, characteristics, and management of patients who had tumor bed recurrence after partial nephrectomy.
We retrospectively reviewed the charts of 2,256 patients with sporadic small renal masses undergoing partial nephrectomy between 2000 and 2014. Local tumor bed recurrence was strictly defined as either: 1) detection of a new enhancing lesion specifically within the surgical defect or 2) detection of a new enhancing lesion within the same region (e.g. lower pole) as the PN site. 44 patients (1.9%) were found to have local recurrence, and compared to 163 randomly selected patients who underwent PN with no recurrence for differences in multiple characteristics.
Patients with local tumor bed recurrence were more likely to have a solitary kidney (27% vs. 4%, p<0.01), and bilateral disease at presentation (23% vs. 10.4%, p=0.02) compared to the group with no recurrence. Positive margins were found in 15.9% of local tumor bed recurrences as compared to 3% of the control group (p<0.01). Median time between partial nephrectomy and detection of local tumor bed recurrence was 23 months (range 2-107 months). Male gender, presence of a solitary kidney at the time of partial nephrectomy, positive surgical margins, presence of multiple tumors, and higher nephrometry score and pathologic staging were associated with local tumor bed recurrence.
Local tumor bed recurrence after partial nephrectomy is associated with several preoperative factors including presence of multiple tumors and a solitary kidney, and intra/post-operative factors such as positive surgical margin and higher pathologic stage.
The Journal of urology. 2017 Sep 20 [Epub ahead of print]
Erika L Wood, Mehrad Adibi, Wei Qiao, Jessica Brandt, Miao Zhang, Pheroze Tamboli, Surena F Matin, Christopher G Wood, Jose A Karam
Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: .