Tumor enucleation specimens of small renal tumors more frequently have a positive surgical margin than partial nephrectomy specimens, but this is not associated with local tumor recurrence

Canine acanthomatous ameloblastoma (CAA) has been reported to be the most common odontogenic tumor in dogs. This retrospective study evaluated 263 dogs with histopathologically confirmed CAA. Within this data set, CAA presents most commonly in the rostral mandible in adult large breed dogs, with golden retriever dogs being overrepresented. Patients with appropriate follow-up after curative intent surgery were evaluated to assess the effect of histopathological margin on local tumor recurrence. No local recurrence was noted in any patient. This study raises questions about what the recommended surgical margin should be for treatment of CAA. It also serves as a stimulus for discussion as to whether further treatment for CAA is required when inadequate surgical margins are obtained, or if medical surveillance would be an appropriate management recommendation. Prospective studies are necessary to answer these questions.

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Comparison of Perioperative, Renal Functional, and Oncological Outcomes Between Off-Clamp and On-Clamp Robot-Assisted Partial Nephrectomy for Renal Tumors: An Updated Evidence-Based Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.730662 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yin Huang ◽

Dehong Cao ◽

Zeyu Chen ◽

Bo Chen ◽

Jin Li ◽

...

Keyword(s):

Partial Nephrectomy ◽

Complication Rate ◽

Conversion Rate ◽

Surgical Margin ◽

Pooled Analysis ◽

Renal Tumors ◽

Positive Surgical Margin ◽

Transfusion Rate ◽

Robot Assisted ◽

Oncological Outcomes

ObjectivesWe aimed to report the latest and largest pooled analysis and evidence update to compare the perioperative, renal functional, and oncological outcomes between off-clamp and on-clamp robot-assisted partial nephrectomy (RAPN) for renal tumors.Patients and methodsWe performed a systematic literature search using PubMed, Embase, and Web of Science up to August 2021 for studies that compared the efficacy and/or safety between off-clamp and on-clamp RAPN for renal tumors. Outcomes measured were operating time, estimated blood loss (EBL), conversion rate, length of stay (LOS), complication rate, transfusion rate, long-term % decrease in estimated glomerular filtration rate (eGFR), positive surgical margin rate, and recurrence rate.ResultsA total of 21 eligible articles involving 4,493 patients (1,274 off-clamp versus 3,219 on-clamp) were included for the evidence synthesis. Baseline characteristics of the two groups were similar in all outcomes except that lower R.E.N.A.L. score and smaller tumor size were observed in the off-clamp group. Pooled analysis showed shorter operative time, higher EBL, and lower complication rate in the off-clamp group. No significant difference was observed in the conversion rate, LOS, and transfusion rate. The recurrence rates were similar in the two groups, while a lower positive surgical margin rate was observed in the off-clamp group. Finally, the off-clamp group had a superior postoperative renal functional outcome.ConclusionsGiven the presence of heterogeneity and potential bias, urologists should select the clamp strategy based on their experience and patient-specific factors.

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Comparison of early experience laparoscopic versus open partial nephrectomy in terms of clinical, oncological and renal functional outcomes

Yeni Üroloji Dergisi ◽

10.33719/yud.2021;16-2-792827 ◽

2021 ◽

pp. 116-123

Author(s):

Mert Kılıç ◽

Meftun Çulpan ◽

Asıf Yıldırım ◽

Turhan Çaşkurlu

Keyword(s):

Local Recurrence ◽

Partial Nephrectomy ◽

Functional Outcomes ◽

Surgical Margin ◽

Renal Tumors ◽

Positive Surgical Margin ◽

Open Partial Nephrectomy ◽

Renal Functions ◽

Estimated Blood Loss ◽

Zero Ischemia

Objective: Although laparoscopic partial nephrectomy (LPN) is minimally invasive, it is also a technically challenging procedure. Currently, open partial nephrectomy (OPN) remains the only alternative in many centers for T1 kidney tumors. We reported our initial experience of LPN compared to OPN regarding clinical, oncological findings and renal functions. Material and Methods: Between 2004-2013, 81 patients who underwent OPN (n=55) or LPN (n=26) for clinically T1 renal tumors were included. Perioperative and postoperative data were compared, retrospectively. Follow-up times for OPN and LPN groups were 72.9± 41.1 and 47.6± 32.4 months, respectively (p<0.05). Results: The mean tumor size and RENAL nephrometry scores were similar for both groups. Zero-ischemia was performed in all of the LPN and 15% of the OPN procedures. Estimated blood loss and perioperative transfusion rates were higher in OPN group. Complications including grade < 3 and ≥ 3 did not differ significantly between the groups. The decrease in creatinine-clearance at 6th month was statistically significant in OPN group, while stable in LPN. Positive surgical margin rates were 6.6% for OPN and 17.6% for LPN, p=0.19. One patient in LPN developed local recurrence and underwent nephrectomy. In OPN group,one local recurrence and one distant metastasis were observed in two independent patients. Both patients recieved tyrosine kinase inhibitor. Conclusion: Although LPN is accepted as a technically challenging procedure, LPN provided comparable outcomes to OPN including clinical, oncological findings and renal functions, even in the early learning phase. Zero-ischemia technique for LPN was feasible and safe with favorable perioperative and renal functional outcomes. Keywords: laparoscopy; learning curve; partial nephrectomy; renal cancer; surgical margins; zero-ischemia.

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PENTAFECTA OUTCOME IN INITIAL 30 CASES OF ROBOT ASSISTED PARTIAL NEPHRECTOMY – OUR EXPERIENCE

10.36106/ijar/3201669 ◽

2020 ◽

pp. 40-41

Author(s):

Jeevan Kumar ◽

Farhana Zakaria ◽

Altaf Khan ◽

Lavanya Raghu Sarath P ◽

Mujeeburahiman M

Keyword(s):

Partial Nephrectomy ◽

Surgical Complications ◽

Surgical Margin ◽

Warm Ischemia ◽

Warm Ischemia Time ◽

Renal Tumors ◽

Positive Surgical Margin ◽

Robot Assisted ◽

Effective Treatment Option ◽

Ischemia Time

Objectives: To study the Pentafecta outcome of initial 30 cases of Robot Assisted Partial Nephrectomy (RAPN) at our institute. Materials and Methods: A total of 30 patients who underwent Robot assisted partial nephrectomy between January 2016 and June 2018 were prospectively analyzed. The Pentafecta outcome was defined as a warm ischemia time (WIT) of <25 min, negative surgical margins, no surgical complications, > 90% of eGFR preservation & no CKD upstaging. Results: All patients successfully underwent robot assisted partial nephrectomy. Median warm ischemia time was 24.5 minutes. One patient with complex tumour had positive surgical margin. There were no Clavien- Dindo Grade IV and V complications. Grade I-III complications were seen in 20% of patients. Conclusion: RAPN is safe and effective treatment option for renal tumors and it helps in improving pentafecta outcome.

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Melanoma Field Cells May Explain Local Tumor Recurrence

Skin & Allergy News ◽

10.1016/s0037-6337(09)70112-3 ◽

2009 ◽

Vol 40 (4) ◽

pp. 6

Author(s):

BRUCE JANCIN

Keyword(s):

Tumor Recurrence ◽

Local Tumor ◽

Local Tumor Recurrence

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Local tumor recurrence at vaginal stump after hysterectomy: comparison of CT and MR imaging

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1993.29.3.480 ◽

1993 ◽

Vol 29 (3) ◽

pp. 480

Author(s):

Jae Min Cho ◽

Seung Hyup Kim ◽

Man Chung Han

Keyword(s):

Mr Imaging ◽

Tumor Recurrence ◽

Local Tumor ◽

Local Tumor Recurrence

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Intradural tumor recurrence after resection of extradural metastasis: a rare but potential complication of intraoperative durotomy

Journal of Neurosurgery Spine ◽

10.3171/2014.3.spine13896 ◽

2014 ◽

Vol 20 (6) ◽

pp. 734-739 ◽

Cited By ~ 3

Author(s):

Manish K. Kasliwal ◽

Lee A. Tan ◽

John E. O'Toole

Keyword(s):

Tumor Recurrence ◽

Spinal Metastasis ◽

Spinal Metastases ◽

Intramedullary Tumor ◽

Local Tumor ◽

Local Tumor Recurrence ◽

Tumor Dissemination ◽

Intradural Tumor ◽

Clinical Consequences ◽

Clinical Awareness

Spinal metastases are the most common of spinal neoplasms and occur predominantly in an extradural location. Their appearance in an intradural location is uncommon and is associated with a poor prognosis. Cerebrospinal fluid dissemination accounts for a significant number of intradural spinal metastases mostly manifesting as leptomeningeal carcinomatoses or drop metastases from intracranial tumors. The occurrence of local tumor dissemination intradurally following surgery for an extradural spinal metastasis has not been reported previously. The authors describe 2 cases in which local intradural and intramedullary tumor recurrences occurred following resection of extradural metastases that were complicated by unintended durotomy. To heighten clinical awareness of this unusual form of local tumor recurrence, the authors discuss the possible etiology and clinical consequences of this entity.

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Feasibility and Techniques of Securing 3D-Safety Margin in Superselective Transarterial Chemoembolization to Improve Local Tumor Control for Small Hepatocellular Carcinoma: An Intend-to-Treat Analysis

Liver Cancer ◽

10.1159/000512337 ◽

2021 ◽

Vol 10 (1) ◽

pp. 63-71

Author(s):

Ching Charoenvisal ◽

Toshihiro Tanaka ◽

Hideyuki Nishiofuku ◽

Hiroshi Anai ◽

Takeshi Sato ◽

...

Keyword(s):

Success Rate ◽

Tumor Recurrence ◽

Safety Margin ◽

Small Hepatocellular Carcinoma ◽

Technical Success ◽

Local Tumor ◽

Local Tumor Recurrence ◽

3D Images ◽

Technical Success Rate ◽

Treat Analysis

Introduction: The aim of this study was to investigate the technical success rate of obtaining 3D-safety margin in superselective conventional transarterial chemoembolization (cTACE) using 3D images for small hepatocellular carcinoma (HCC). Methods: Consecutive 48 HCC nodules (diameter, 1–3 cm) in 44 patients were intentionally treated by superselective cTACE in an attempt to achieve 3D-safety margin. Superselective CT during hepatic arteriography (CTHA) was obtained before cTACE. When negative 3D-safety margin was found, branches supplied into the margin area were detected by using a 3D workstation. The technical success rate to obtain 3D-safety margin was investigated by intend-to-treat analysis. Local tumor recurrence rate and adverse events were also evaluated. Result: Nine of 48 tumors (18.8%) had 3D-safety margin in the initial superselective CTHA. After pulling back of the catheter and/or selection of another branch based on 3D images, 3D-safety margin was finally achieved in 45 (93.8%). There were 8 of 46 tumors (17.4%) with local recurrence after 5-year follow-up. Grade 3–4 of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were found in 38.6, 36.4, and 2.3%, respectively. One portal vein thrombus and 3 biliary dilation or biloma were developed. Conclusion: Superselective cTACE obtaining 3D-safety margin in small HCC was feasible with a high success rate by using 3D images, which could be tolerable and prevent local tumor recurrence.

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