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ZHAO Guo-bin, WANG Yu, TANG Yu-hong, et al. The Optimal Surgical Margins of Nephron-sparing Surgery for Stage T1b Renal Tumors[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(4): 552-555. DOI: 10.12182/20200760504
Citation: ZHAO Guo-bin, WANG Yu, TANG Yu-hong, et al. The Optimal Surgical Margins of Nephron-sparing Surgery for Stage T1b Renal Tumors[J]. Journal of Sichuan University (Medical Sciences), 2020, 51(4): 552-555. DOI: 10.12182/20200760504

The Optimal Surgical Margins of Nephron-sparing Surgery for Stage T1b Renal Tumors

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  • Received Date: January 04, 2020
  • Revised Date: April 14, 2020
  • Available Online: July 20, 2020
  • Published Date: July 19, 2020
  •   Objective  To analyze the pathological characteristics and explore the optimal surgical margins (SM) of nephron-sparing surgery (NSS) for stage T1b renal carcinoma (4–7 cm) on preoperative imaging.
      Methods  The clinical and pathological data of 245 cases of stage T1b kidney cancer from September 2013 to December 2017 were collected and reviewed retrospectively. The radical nephrectomy (RN) was performed on 174 cases and other 71 cases accepted NSS. There were 158 males and 87 females, with a mean age of 59.6 years and mean tumor size of 5.3 cm.
      Results  Through postoperative pathological examination, 209 (85.3%) cases were confirmed renal clear cell carcinoma and 219 (89.4%) cases were surrounded with visible peritumoralpseudocapsule (PC). 26 (10.6%) cases of cancerous cells invaded beyond peritumoral PC and into renal parenchyma. The infiltrative depth into renal parenchyma beyond PC was all limited in 3 mm and the cases of ≤1, 1-2 and 2-3 mm were 7 (26.9%), 16 (61.5%) and 3 (11.5%), respectively. Multifocal tumors were discovered in 24 (9.8%) cases. The average resection margin for partial nephrectomy was 5 mm (3-7 mm).
      Conclusion  For stage T1b renal tumors, NSS is acceptable and a 3 mm of surgical margin is safe and suitable to avoid positive SM.
  • [1]
    LEBACLE C, POOLI A, BESSEDE T, et al. Epidemiology, biology and treatment of sarcomatoid RCC: current state of the art. World J Urol,2019,37(1): 115–123. DOI: 10.1007/s00345-018-2355-y
    [2]
    EDGE S B, COMPTON C C. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol,2010,17(6): 1471–1474. DOI: 10.1245/s10434-010-0985-4
    [3]
    CAPITANIO U, TERRONE C, AATONELLI A, et al. Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. Eur Urol,2015,67(4): 683–689. DOI: 10.1016/j.eururo.2014.09.027
    [4]
    COOPERBERG M R, MALLIN K, KANE C J, et al. Treatment trends for stage I renal cell carcinoma. J Urol,2011,186(2): 394–399. DOI: 10.1016/j.juro.2011.03.130
    [5]
    ZHANG K, XIE W L. Determination of the safe surgical margin for T1b renal cell carcinoma. Urol J,2017,14(1): 2961–2967.
    [6]
    KUTIKOV A, UZZO R G. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol,2009,182(3): 844–853. DOI: 10.1016/j.juro.2009.05.035
    [7]
    FERLAY J, SHIN H R, BRAY F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer,2010,127(12): 2893–2917. DOI: 10.1002/ijc.25516
    [8]
    SHIN S J, KO K J, KIM T S, et al. Trends in the use of nephron-sparing surgery over 7 years: an analysis using the R.E.N.A.L. nephrometry scoring system. PLoS One,2015,10(11): e0141709[2019-07-02]. https://doi.org/10.1371/journal.pone.0141709.
    [9]
    晁流, 刘宁, 甘卫东, 等. 保留肾单位术与根治性肾切除术对肾功能影响的比较. 中华腔镜泌尿外科杂志(电子版),2017,11(6): 393–397. DOI: 10.3877/cma.j.issn.1674-3253.2017.06.009
    [10]
    LEIBOVICH B C, BLUTE M, CHEVILLE J C, et al. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J Urol,2004,171(3): 1066–1070. DOI: 10.1097/01.ju.0000113274.40885.db
    [11]
    LEE H J, LISS M A, DERWEESH I H. Outcomes of partial nephrectomy for clinical T1b and T2 renal tumors. Curr Opin Urol,2014,24(5): 448–452. DOI: 10.1097/MOU.0000000000000081
    [12]
    ZUCCHI A, MEARINI L, MEARINI E, et al. Renal cell carcinoma: histological findings on surgical margins after nephron sparing surgery. J Urol,2003,169(3): 905–908. DOI: 10.1097/01.ju.0000046779.58281.c4
    [13]
    AKCETIN Z, ZUGOR V, ELSASSER D, et al. Does the distance to normal renal parenchyma (DTNRP) in nephron-sparing surgery for renal cell carcinoma have an effect on survival? Anticancer Res,2005,25(3A): 1629–1632.
    [14]
    秦晓健, 张海梁, 叶定伟, 等. 临床T1b期肾癌选择性保留肾单位手术分析. 中华泌尿外科杂志,2013,34(3): 167–170. DOI: 10.3760/cma.j.issn.1000-6702
    [15]
    CHEN X S, ZHANG Z T, DU J, et al. Optimal surgical margin in nephron-sparing surgery for T1b renal cell carcinoma. Urology,2012,79(4): 836–839. DOI: 10.1016/j.urology.2011.11.023
    [16]
    RICHSTONE L, SCHERR D S, REUTER V R, et al. Multifocal renal cortical tumors: frequency, associated clinicopathological features and impact on survival. J Urol,2004,171(2 Pt 1): 615–620. DOI: 10.1097/01.ju.0000106955.19813.f6
    [17]
    SARGIN S Y, EKMEKCIOGLU O, ARPALI E, et al. Multifocality incidence and accompanying clinicopathological factors in renal cell carcinoma. Urol Int,2009,82(3): 324–329. DOI: 10.1159/000209366
    [18]
    SIRACUSANO S, NOVARA G, ANTONELLI A, et al. Prognostic role of tumourmultifocality in renal cell carcinoma. BJU Int,2012,110(11 Pt B): E443–E448. DOI: 10.1111/j.1464-410X.2012.11121.x
    [19]
    LI G, LUO Q, LANG Z, et al. Histopathologic analysis of stage pT1b kidney neoplasms for optimal surgical margins of nephron-sparing surgery. Clin Trans Oncol,2018,20(9): 1196–1201. DOI: 10.1007/s12094-018-1845-0
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