The effect of surgical margin on cancer-specific survival in patients treated with nephron-sparing surgery

Kızılay, Fuat; Eskidemir, Ümit; Bahçeci, Tuncer; Şimşir, Adnan; Özdemir, Hüseyin Nezih; Sarsik, B; Turna, Burak

doi:10.4103/njcp.njcp_267_18

Cited by 3 publications

(6 citation statements)

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“…Finally, 39 CCSs ( 4 , 6 – 8 , 11 – 45 ), with a total of 21461 patients were included, from which 1278 patients were assigned to the PSM group and 20183 cases to the NSM group. In addition, these studies were carried out from 13 countries in Europe, North America, South America, and Asia.…”

Section: Resultsmentioning

confidence: 99%

“…We extracted data on local recurrence in two groups from 33 studies ( 4 , 6 , 11 – 15 , 17 – 23 , 25 – 30 , 32 – 38 , 40 – 45 ) including 13473 patients (PSM: 785, NSM: 12688). In 8 studies ( 13 , 14 , 18 – 21 , 36 , 38 ), the OR value could not be calculated because the number of local recurrence was zero in both the PSM and NSM groups.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty studies provided comparative data on tumor metastasis between the two groups ( 4 , 6 , 13 – 15 , 17 , 18 , 20 , 25 , 27 , 30 , 33 – 36 , 38 , 40 – 43 ), including 434 patients in the PSM group and 8298 patients in the NSM group. In 4 studies ( 13 , 14 , 35 , 36 ), the number of metastatic cases in the two groups was zero, and the OR value could not be calculated.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies including 10155 patients reported data on all-cause death in two groups ( 4 , 7 , 8 , 16 – 18 , 24 , 25 , 31 , 32 , 39 , 44 ), from which a significantly higher rate of all-cause death in the PSM group could be found than that in the NSM group (OR 1.51, 95% CI 1.19-1.93; p = 0.0008; Figure 4 ). However, subgroup analyses showed insignificant results between the two groups for those less than 3 years (OR 2.08, 95% CI 0.62-7.01; p = 0.24) and those more than 6 years (OR 1.26, 95% CI 0.73-2.17; p = 0.40) ( Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…According to the surgeons’ preference along with the feasibility of technology, a robot-assisted, pure laparoscopic or open method can be chosen for PN. Theoretically, the purpose of the operation is to completely remove the tumor and provide a negative surgical margin (NSM) while preserving as much normal renal parenchyma as possible ( 4 ). However, positive surgical margins (PSM) occasionally occur, with an incidence of 2-8% ( 5 ), which is defined as the presence of cancer cells at the parenchymal inked margin of resection.…”

Section: Introductionmentioning

confidence: 99%

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Positive surgical margins may not affect the survival of patients with renal cell carcinoma after partial nephrectomy: A meta-analysis based on 39 studies

et al. 2022

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BackgroundSo far, whether positive surgical margin(PSM) has adverse effects on the prognosis of patients is still controversial, so we designed this study to systematically evaluate the effect of PSM on the prognosis of patients with renal cell carcinoma (RCC) after partial nephrectomy (PN).MethodsOn the basis of three electronic databases (PubMed, Embase and the Cochrane Library) up to May 2022, all case–control studies (CCSs) comparing the effects of PSM and negative surgical margin (NSM) after PN on the oncological results of RCC patients were included. Two evaluators independently conducted a systematic literature search and extracted the data we needed. The methodological quality of all studies was evaluated by the modified Newcastle–Ottawa scale. The odds ratio (OR) was used to describe the results for dichotomous variables, and the meta-analysis was conducted using Cochrane Review Manager 5.2 and Stata 14.2.ResultsA total of 39 studies involving 21461 patients were included in our meta-analysis. The pooled results showed that the rates of tumor recurrence (OR 3.93, 95% CI 2.95-5.24; p < 0.00001) and metastasis (OR 4.63, 95% CI 3.11-6.88; p < 0.00001) in the PSM group were significantly higher than those in the NSM group. However, there were no significant differences in the rates of all-cause death (OR 1.35, 95% CI 0.92-1.99; p = 0.13) or cancer-specific death (OR 0.99, 95% CI 0.51-1.94; p = 0.99) between the two groups. In addition, subgroup analyses were carried out according to different average follow-ups, which revealed similar results.ConclusionInsignificant differences in survival between the PSM and NSM groups were observed, although significant differences in recurrence and metastasis in the PSM group were reported. Our study supported that close monitoring might be another effective choice for patients with PSM after PN. Considering the possible limitations, we recommended cautious interpretation of our results.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Positive surgical margins may not affect the survival of patients with renal cell carcinoma after partial nephrectomy: A meta-analysis based on 39 studies

et al. 2022

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Effect of Positive Surgical Margins in Patients Who Undergo a Partial Nephrectomy Regarding Recurrence, Overall Survival, Recurrence/Progression-Free Survival, and Metastasis-Free Survival. A Systematic Review and Meta-Analysis

García‐Perdomo

Caparrós

Asensio

et al. 2022

Clinical Genitourinary Cancer

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Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review

Pandolfo,

Wu,

Campi

et al. 2024

Cancers

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Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of RAPN when dealing with entirely central hilar masses and to examine the various methods used to address the surgical difficulties associated with them. Methods: A thorough literature search in September 2023 across various databases focused on RAPN for renal hilar masses, adhering to PRISMA guidelines. The primary goal was to evaluate RAPN’s surgical and functional outcomes, with a secondary aim of examining different surgical techniques. Out of 1250 records, 13 full-text manuscripts were reviewed. Results: Evidence is growing in favor of RAPN for renal hilar masses. Despite a predominance of retrospective studies and a lack of long-term data, RAPN shows positive surgical outcomes and preserves renal function without compromising cancer treatment effectiveness. Innovative suturing and clamping methods are emerging in surgical management. Conclusions: RAPN is a promising technique for managing renal hilar masses in RCC, offering effective surgical outcomes and renal function preservation. The study highlights the need for more long-term data and prospective studies to further validate these findings.

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The effect of surgical margin on cancer-specific survival in patients treated with nephron-sparing surgery

Cited by 3 publications

References 0 publications

Positive surgical margins may not affect the survival of patients with renal cell carcinoma after partial nephrectomy: A meta-analysis based on 39 studies

Positive surgical margins may not affect the survival of patients with renal cell carcinoma after partial nephrectomy: A meta-analysis based on 39 studies

Effect of Positive Surgical Margins in Patients Who Undergo a Partial Nephrectomy Regarding Recurrence, Overall Survival, Recurrence/Progression-Free Survival, and Metastasis-Free Survival. A Systematic Review and Meta-Analysis

Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review

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