Is a 1-cm margin necessary during nephron-sparing surgery for renal cell carcinoma?

Natania Y. Piper, Jay T. Bishoff, Christopher Magee, Jason M. Haffron, Robert C. Flanigan, Annemieke Mintiens, Hein P. Van Poppel, Ian M. Thompson, William J. Harmon

Research output: Contribution to journalArticlepeer-review

89 Scopus citations

Abstract

Objectives. To determine whether a 1-cm margin is necessary for cancer control during nephron-sparing surgery (NSS) for renal cell carcinoma (RCC). Methods. A retrospective review of 67 patients who underwent NSS for RCC between 1990 and 2000 was conducted. The data collected included patient demographics, tumor size and location, histologic type and grade, margin status (positive or negative), and the shortest distance of normal parenchyma (in millimeters) around the tumor in the final pathologic specimen. Recurrence was determined from the clinical follow-up, which included physical examination, ultrasonography or computed tomography, and various laboratory tests. Results. Fifty-five cases were performed open and 12 laparoscopically. The mean follow-up was 60 months (range 5 to 124). The mean tumor size was 3.0 cm (range 0.9 to 11.0). Seven patients were found to have a positive margin; 1 died of metastatic RCC, 1 was alive with systemic recurrence, and 5 had no evidence of disease. Of 11 patients with a negative margin distance of less than 1 mm, 9 were recurrence free, 1 had simultaneous local and pulmonary relapse, and the other had pulmonary recurrence only. The remainder of the study patients (n = 49) had negative margins greater than 1 mm, and all were alive without evidence of disease at the last follow-up. Conclusions. This review questions the necessity of a 1-cm margin to prevent recurrence after NSS for RCC. Additional studies to determine the optimal margin distance should be conducted.

Original languageEnglish (US)
Pages (from-to)849-852
Number of pages4
JournalUrology
Volume58
Issue number6
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Is a 1-cm margin necessary during nephron-sparing surgery for renal cell carcinoma?'. Together they form a unique fingerprint.

Cite this