학술논문
Positive surgical margin's impact on short-term oncological prognosis after robot-assisted partial nephrectomy (MARGINS study: UroCCR no 96).
Document Type
Article
Author
Morrone, Arnoult; Bentellis, Imad; Bernhard, Jean-Christophe; Bensalah, Karim; Champy, Cécile; Bruyere, Franck; Doumerc, Nicolas; Olivier, Jonathan; Audenet, François; Parier, Bastien; Brenier, Martin; Long, Jean-Alexandre; Nouhaud, François-Xavier; Branger, Nicolas; Lang, Hervé; Charles, Thomas; Xylinas, Evanguelos; Waeckel, Thibaut; Gomez, Florie; Boissier, Romain
Source
Subject
*SURGICAL margin
*PROPORTIONAL hazards models
*SURGICAL robots
*NEPHRECTOMY
*PROGNOSIS
*RENAL cell carcinoma
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Language
ISSN
2045-2322
Abstract
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. [ABSTRACT FROM AUTHOR]