The Prognostic Impact of a Positive Vascular Margin on @entity1803 XXXX .

@entity1 @entity1803 @entity5 @entity1358 @entity3
PURPOSE: We examined the impact of positive vascular margins in @entity1 with @entity1803 @entity1358 . MATERIALS AND METHODS: After excluding @entity1 with nonvascular positive margins, @entity3 , lymph node involvement, neoadjuvant therapy or nonclear cell histology, we identified 224 @entity1 with @entity5 invasion through our institutional database from 1999 to 2013. Kaplan-Meier analysis and log rank tests were used to evaluate whether positive vascular margins were associated with progression-free survival or @entity5 specific survival. RESULTS: There were 41 @entity1 (18%) with a positive vascular margin. Margin status was directly related to the level of invasion (p <0.0001). Compared to the negative vascular margin group the positive group had a significantly worse progression-free survival (p=0.01) but not @entity5 specific survival (p=0.3). Similarly the level of vascular thrombus invasion was significantly associated with worse progression-free survival (p=0.02) but not @entity5 specific survival (p=0.4). The 3-year progression-free survival was worst with inferior vena cava invasion and @entity3 (54%, 95% CI 34-70 vs 76%, 95% CI 64-85). Among @entity1 with only main renal vein thrombus, vascular margin status was not associated with progression-free survival (p=0.5) or @entity5 specific survival (p=0.2). CONCLUSIONS: In @entity1 with pT3N0/XM0 @entity1358 positive vascular margins are associated with risk of disease progression. However, the risk of relapse associated with positive vascular margins is driven by the extent of vascular thrombus invasion. These findings suggest that the clinical significance of vascular margin status as currently defined in @entity1803 @entity1358 is minimal.
