Márgenes positivos tras nefrectomía parcial en carcinoma de células renales: seguimiento a largo plazo y resultados oncológicos con manejo conservador |
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| Institution: | 1. Service d’urologie, Nouvel Hopital Civil, 1, place de l''Hopital, 67000 Strasbourg, France;2. Clinique RHENA, 10, rue Francois-Epailly, France;3. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA;1. Department of Urology, Haseki Training and Research Hospital, Estambul, Turquía;2. Department of Urology, Kucukyali Delta Hospital, Estambul, Turquía;3. Department of Urology, Konya Training and Research Hospital, Iconio, Turquía;4. Department of Urology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Estambul, Turquía;1. Hospital Universitario Germans Trias i Pujol, Barcelona, España;2. Hospital Universitario Vall d’Hebron, Barcelona, España;3. Universitat Autónoma de Barcelona, Barcelona, España;1. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY;2. Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY;3. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY;1. Department of Urology, University of Heidelberg, Heidelberg, Germany;2. Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China;3. Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany |
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| Abstract: | IntroductionPartial nephrectomy (PN) is the standard treatment for small and localized kidney tumours (cT1). One of the controversial aspects regarding this technique is the management of affected/positive resection margins. We present the long-term oncological results in patients with PSM after PN managed conservatively.Material and methodsThere were 207 PN performed in our centre between 1990 and 2011. 17 patients presented PSM. 2 patients were excluded from the study due to completion nephrectomy afterwards. Follow-up was was done with abdominal contrast-enhanced computed tomography every 6 months for the first 2 years and subsequently, once a year. Cancer-specific survival and disease-free survival were calculated with the Kaplan-Meier method.ResultsThe median age was 62 years (RIQ: 55-71) and the mean tumour size was 34.8 (10-77) mm. Histopathological results were: 6 (40%) clear cell RCC, 4 (26.7%) papillary, 3 (20%) chromophobe and 2 (13.3%) oncocytic. The pathologic stages were: 11 (73.3%) pT1a, 1 (6.7%) pT1b and 3 (20%) pT3a. The median follow-up was 84 months (IQR 72-120). 2 patients had metastatic recurrence and this was the cause of death. The first one had recurrence at 112 months and the second one at 59. 5-year CSS and RFS were 87.5% and 93.3% respectively.ConclusionsIn our experience, patients with PSM after PN can be managed conservatively with satisfactory long-term oncological outcomes. |
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| Keywords: | Partial nephrectomy Renal cell carcinoma Positive margins |
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