Partial nephrectomy for renal tumors: lack of correlation between margin status and local recurrence.
OBJECTIVES
To evaluate the relationship between a positive resection margin in partial nephrectomy (PN) and local recurrence.


METHODS
From January 2005 through December 2012, there were 473 PNs in 466 patients at the University of Chicago. A positive margin was defined as tumor extending to the inked specimen edge, either the parenchymal interface or the peripheral fibroadipose tissue. A local recurrence was defined as an ipsilateral tumor of identical histologic type.


RESULTS
Renal cell carcinoma (RCC) accounted for 406 tumors: 243 clear cell RCCs (CRCCs), 77 papillary RCCs (PRCCs), and 47 chromophobe RCCs (CHRCCs). Sixty-one RCCs had positive margins: 43 CRCCs, six PRCCs, nine CHRCCs, and three miscellaneous cell types. Of the 61 positive margins, four CRCCs (all originally multifocal) had a local recurrence, two of which occurred in the same patient. One translocation RCC also recurred. Six cases with negative resection margins had a recurrence.


CONCLUSIONS
A literature review of 3,803 cases, including our study, shows positive margins in 173, of which 13 recurred; however, 39 with negative margins also recurred. A positive margin in PN seldom correlates with a local recurrence. However, protection from recurrence is not ensured by a negative margin.
['Antic|Tatjana|T|', 'Taxy|Jerome B|JB|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002292:Carcinoma, Renal Cell D004502:Education, Medical, Continuing D005260:Female D006801:Humans D007680:Kidney Neoplasms D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D009392:Nephrectomy D012189:Retrospective Studies D055815:Young Adult
Partial nephrectomy Local recurrence Renal cell carcinoma