Predictive Factors for Ipsilateral Recurrence After Nephron-sparing Surgery in Renal Cell Carcinoma

Bernhard, Jean-Christophe; Pantuck, Allan J.; Wallerand, Hervé; Crépel, Maxime; Ferrière, Jean-Marie; Bellec, L.; Maurice-Tison, S.; Robert, G.; Albouy, Baptiste; Pasticier, G.; Soulié, M.; Lopes, David; Lacroix, B.; Bensalah, Karim; Pfister, Christian; Thuret, Rodolphe; Tostain, Jacques; Taille, Alexandre de la; Salomon, Laurent; Abbou, C.C.; Colombel, Marc; Belldegrun, Arie S.; Patard, Jean‐Jacques

doi:10.1016/j.eururo.2010.02.019

Cited by 67 publications

(43 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although currently debated, early studies of the clinical implications of positive margins demonstrated a higher risk of tumor recurrence and should be avoided in all cases. 25,26 Even when a positive margin never evolves into a clinically significant recurrence, the impact of rigorous surveillance may carry with it both a financial and emotion burden to the patient 27,28 The i-Cap scoring system can provide an essential tool not only to the pathologist but also to the treating urologist to aid in the creation of an appropriate post-operative care plan for the renal cell cancer patient.…”

Section: Discussionmentioning

confidence: 99%

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

View full text Add to dashboard Cite

KEY OF DEFINITIONS FOR ABBREVIATIONS:Renal tumor enucleation allows for maximal parenchymal preservation. Identifying pseudocapsule integrity is critically important in nephron sparing surgery by enucleation. Tumor invasion into and through capsule may have clinical implications although it is not routinely commented on in standard pathologic reporting. We sought to describe a system to standardize the varying degrees of pseudocapsule invasion and to identify predictors of invasion. Materials and Methods:A multicenter retrospective review was carried out between

show abstract

Section: Discussionmentioning

confidence: 99%

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

et al. 2017

View full text Add to dashboard Cite

show abstract

“…High-volume studies have not necessarily proved a clear correlation. 18,19 Nevertheless, some have demonstrated that PSM influences tumor recurrence rate, 20,21 but does not appear to have an effect on cancer-specific survival, 21 suggesting that conclusions should not be drawn without long-term follow-up. The prevalence of PSM in nephron-sparing techniques has been reported to be in the range of 4.9–8.1% for the open and laparoscopic approaches.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy for T1b Tumors: Strict Trifecta Outcomes

Tüfek

Mourmouris

Doğanca

et al. 2017

JSLS

View full text Add to dashboard Cite

Background and Objectives:“Trifecta” in partial nephrectomy consists of negative surgical margins, minimal renal function decrease and absence of complications. In the present article, our single-center robot-assisted partial nephrectomy (RAPN) experience in T1b renal masses is reported in terms of strict Trifecta outcomes.Methods:This is a retrospective analysis of patients with a tumor diameter between 4 and 7 cm (stage T1b), who underwent RAPN by a single surgeon. Preoperative, intraoperative, and postoperative data were recorded and analyzed to evaluate short-term functional and oncologic outcomes. Patients with absence of grade ≥ 2 Clavien-Dindo complications, warm ischemia time (WIT) ≤25 minutes, ≤15% postoperative estimated glomerular filtration rate (eGFR) decrease and negative surgical margins were reported to achieve strict Trifecta outcomes. P < .05 was indicated statistically significant.Results:A total of 150 patients underwent RAPN, and 50 patients were identified with tumor size between 4 and 7 cm. Mean WIT was 20.8 ± 6.2 minutes and mean estimated blood loss (EBL) was 269 ± 191 mL. Surgical margins were negative in all patients. Eleven patients (22%) had a >15% eGFR decrease after surgery. Nine patients (18%) had WIT longer than 25 minutes. Four patients (8%) had grade ≥2 Clavien-Dindo complications. Twenty-nine (58%) patients had strict Trifecta outcomes. Mean follow-up was 44.2 ± 27.2 months. Tumor recurrence was not observed in any patient.Conclusions:Robot-assisted laparoscopic partial nephrectomy for T1b renal masses can be safely performed in experienced hands. Optimal strict Trifecta outcomes and recurrence rates can be achieved.

show abstract

“…The presence of R1 findings when the resection bed is grossly tumor-free has not been shown to have any significant effect on tumor-specific survival (19) (LoE 3). Patients with R1 findings are at increased risk of local recurrence (hazard ratio [HR] 11.5); note, however, that the data underlying this finding concerned a small group of patients (20) (LoE 3). If the definitive histopathological examination reveals R1 findings, then surveillance is indicated, rather than a second operation (21) (LoE 3, recommendation grade B).…”

Section: Resection Marginsmentioning

confidence: 59%

The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma

Doehn¹,

Grünwald²,

Steiner³

et al. 2016

Deutsches Ärzteblatt International

View full text Add to dashboard Cite

show abstract

Predictive Factors for Ipsilateral Recurrence After Nephron-sparing Surgery in Renal Cell Carcinoma

Abstract: RCC ipsilateral recurrence risk after NSS is significantly associated with tumour size >4cm, tumour bilaterality (synchronous or asynchronous), and PSM. Careful follow-up should be advised in patients presenting with such characteristics.

Cited by 67 publications

References 28 publications

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

Standardized Reporting of Microscopic Renal Tumor Margins: Introduction of the Renal Tumor Capsule Invasion Scoring System

Robot-Assisted Partial Nephrectomy for T1b Tumors: Strict Trifecta Outcomes

The Diagnosis, Treatment, and Follow-up of Renal Cell Carcinoma

Contact Info

Product

Resources

About