Prognostic Factors for Surgical Margin Status and Recurrence in Partial
Nephrectomy
Abstract
Purpose: To evaluate the prognostic factors affecting surgical margin
and recurrence in patients who underwent partial nephrectomy for renal
masses. Materials and Methods: Data of 125 patients who underwent open
or laparoscopic partial nephrectomy due to renal mass between January
2006 and January 2019 were analyzed retrospectively. Demographic data,
habits, additional diseases, clinical and laboratory findings,
operational data, the morphology of the tumor in computerized tomography
or magnetic-resonance imaging and follow-up data were scanned and
acquired via our hospital’s system and archive. Results: Average age was
54.4, male-female ratio was 1.55 and average tumor size was 3.31 cm. 104
patients had malignant pathology and 21 was benign. Positive surgical
margin rate was 5.6% and recurrence rate was 3.2%. Average follow-up
was 47.4 months. Pathological size of the tumor was larger (p=0.006),
warm-ischemia period was lower (p=0.003), and PADUA score was higher
(p=0.015) in open technique. Tumor size and tumor stage were
statistically higher in patients with recurrence (p=0.009,
p<0.001 respectively). No statistically significant difference
was observed between surgical margin positivity and tumor size, Fuhrman
grades, PADUA scores, R.E.N.A.L. scores, and C-index.
(p>0.05) Conclusion: Surgical margin positivity after
partial nephrectomy is not significantly associated with tumor
characteristics and anatomical scoring systems. Tumor size and stage
after partial nephrectomy are valuable parameters in evaluating the
recurrence risk. Keywords: nephrectomy, recurrence, margins of excision,
prognosis