scholarly journals The Clinical Significance of the Extent of Positive Surgical Margins in Partial Nephrectomy performed for Renal Cell Carcinoma

2021 ◽  
Author(s):  
Ziting Wang ◽  
Yi Quan Tan ◽  
Jirong Lu ◽  
Yen Seow Benjamin Goh ◽  
Kep Yong Loh ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operative Time ◽  
Surgical Margins ◽  
Cell Type ◽  
Positive Surgical Margins ◽  
Positive Margins ◽  
Local Recurrences ◽  
Male Patients ◽  
Perinephric Fat

Abstract PurposeThis study aims to review the occurrences of extensive positive surgical margins and focal positive surgical margins after partial nephrectomy for kidney cancer, comparing their associations and clinical outcomes with those with negative surgical margins. Materials and MethodsBetween 2014 to 2019, a total of 137 partial nephrectomies for cancer was performed. Pathological surgical margins were classified according to negative surgical margins (n=156), extensive positive margins (n=7), or focal positive surgical margins (n=15). Peri-operative data, functional and oncological outcomes were compared among the three groups.ResultsBaseline clinical characteristics were comparable in all three groups except for gender, with a significantly greater proportion of male patients (P=0.02) with extensive positive surgical margins and focal positive surgical margins than negative surgical margins. Negative surgical margins was associated with shorter operative time compared with extensive and focal positive surgical margins. Pathologically, perinephric fat invasion was significantly associated (P<0.01) with positive surgical margins but there were no other differences in terms of cell type, grade and necrosis. There were a total of 4 local recurrences, all in the extensive positive surgical margins group with a median follow up period of 32.8 months.ConclusionsExtensive positive surgical margins and focal positive surgical margins share similar peri-operative associations when compared with negative surgical margins but have different pathological and oncological implications to each other. The higher association of pathological T3a stage with extensive positive margins may account for the finding that local recurrences exclusively occur in patients with extensive positive surgical margins.

scholarly journals Retroperitoneal hand-assisted laparoscopic nephrectomy and partial nephrectomy

2013 ◽  
Vol 3 (1) ◽  
pp. 3 ◽  
Author(s):  
Nosratollah Nezakatzgoo ◽  
Janet Colli ◽  
Matthew Mutter ◽  
Sheg Aranmolate ◽  
Robert Wake
Keyword(s):  
Partial Nephrectomy ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Oral Intake ◽  
Pathological Examination ◽  
Tumor Diameter ◽  
Renal Masses ◽  
Estimated Blood Loss ◽  
Average Operative Time

The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the Harmonic scalpel or Ligasure device. Hemostatic agents were used to cover the renal defect. Surgical bolsters were sutured to the renal capsule with pleget reinforcements to aid in hemostasis. The average operative time was 210 min and estimated blood loss 110 mL. Mean change in hematocrit was 3 units and creatinine was 1 point. No patient required a transfusion. There were no major complications, with a mean follow-up of fourteen months. On average, patients resumed oral intake in 2 days, and were discharged in 3 days. Pathological examination revealed that two lesions were benign and seven malignant. Tumor diameter averaged 3 cm. There were no positive surgical margins. In conclusion, we have demonstrated the feasibility of retroperitoneal laparoscopic hand-assisted nephrectomy and partial nephrectomy surgery for solid renal masses.

scholarly journals Impact of Positive Surgical Margins After Partial Nephrectomy

2020 ◽  
Vol 21 ◽  
pp. 41-46
Author(s):  
João André Mendes Carvalho ◽  
Pedro Nunes ◽  
Edgar Tavares-da-Silva ◽  
Belmiro Parada ◽  
Roberto Jarimba ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Surgical Margins ◽  
Positive Surgical Margins

Defining predictors of early, intermediate, and late biochemical recurrence in men with clinically localized prostate cancer treated with minimally invasive radical prostatectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 113-113
Author(s):  
Silvia Garcia Barreras ◽  
Igor Nunes-Silva ◽  
Rafael Sanchez-Salas ◽  
Fernando P. Secin ◽  
Victor Srougi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Biochemical Recurrence ◽  
Surgical Margins ◽  
Positive Surgical Margins

113 Background: Follow up after radical prostatectomy should be tailored to clinical and pathologic characteristics. To determine predictive factors for early, intermediate and late biochemical recurrence (BCR) after minimally invasive radical prostatectomy (MIRP: lap and robot) in patients with localized prostate cancer (PCa). Methods: Prospective clinical, pathologic, and outcome data were collected for 6195 patients with cT1-3N0M0 PCa treated with MIRP at our institution from 2000 to 2016. None of them received neoadjuvant therapy. BCR was defined as PSA level greater than 0.2 ng/ml. Time to BCR was divided in terciles to identify variables associated with early ( < 12 months), intermediate (12-36 months) and late BCR ( > 36 months). Comparisons among groups were performed using ANOVA or Chi square test. Logistic regression models were built to determine risk factors associated with BCR at each time interval. Results: We identified 1148 (19%) patients with BCR. Median time to BCR was 24 months. Statistically significant differences were found between the groups concerning PSA preoperative, D’Amico risk, type of surgery, pT stage, pathological Gleason, positive margins and extracapsular extension. Multivariable logistic regression analysis showed preoperative PSA, positive nodes, positive surgical margins and laparoscopic surgery were associated with early BCR. Laparoscopic surgery was the only risk factor associated with intermediate term BCR. Significant predictors of late BCR included Gleason ≥ 7, ≥ pT3, positive surgical margins, lymph node dissection performance and laparoscopic surgery. Conclusions: Patients with high risk features like Gleason ≥ 7, ≥ pT3 and or positive surgical margins may develop late recurrence and deserve long term follow up. Identify patients with higher PSA and lymph node invasion has an important predictive role due to the risk of BCR within the first year. The association between laparoscopic technique and late BCR deserves further evaluation.

Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face

2015 ◽  
Vol 41 (7) ◽  
pp. 761-767 ◽  
Author(s):  
Aykut Bozan ◽  
Sercan Gode ◽  
Isa Kaya ◽  
Banu Yaman ◽  
Mustafa Uslu ◽  
...  
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Surgical Margins ◽  
Positive Surgical Margins ◽  
Long Term Follow Up ◽  
The Face
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