Positive surgical margins in robot-assisted partial nephrectomy: A multi-institutional analysis of oncologic outcomes (Leave no tumor behind)

Ali Khalifeh, Jihad H. Kaouk, Sam Bhayani, Craig Rogers, Michael Stifelman, Youssef S. Tanagho, Ramesh Kumar, Michael Gorin, Ganesh Sivarajan, Dinesh Samarasekera, Mohamad E Allaf

Research output: Contribution to journalArticle

Abstract

Purpose: Expanding indications for robot-assisted partial nephrectomy raise major oncologic concerns for positive surgical margins. Previous reports showed no correlation between positive surgical margins and oncologic outcomes. We report a multi-institutional experience with the oncologic outcomes of positive surgical margins on robot-assisted partial nephrectomy. Materials and Methods: Pathological and clinical followup data were reviewed from an institutional review board approved, prospectively maintained joint database from 5 institutions. Tumors with malignant pathology were isolated and statistically analyzed for demographics and oncologic followup. The log rank test was used to compare recurrence-free and metastasis-free survival between patients with positive and negative surgical margins. The proportional hazards method was used to assess the influence of multiple factors, including positive surgical margins, on recurrence and metastasis. Results: A total of 943 robot-assisted partial nephrectomies for malignant tumors were successfully completed. Of the patients 21 (2.2%) had positive surgical margins on final pathological assessment, resulting in 2 groups, including the 21 with positive surgical margins and 922 with negative surgical margins. Positive surgical margin cases had higher recurrence and metastasis rates (p

Original languageEnglish (US)
Pages (from-to)1674-1679
Number of pages6
JournalJournal of Urology
Volume190
Issue number5
DOIs
Publication statusPublished - Nov 2013

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Keywords

  • Carcinoma
  • Kidney
  • Nephrectomy
  • Pathology
  • Renal cell
  • Robotics

ASJC Scopus subject areas

  • Urology

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