Impact of resection margin status after nephron-sparing surgery for renal cell carcinoma.

OBJECTIVE: To evaluate whether the negative-margin width after nephron-sparing surgery for renal cell carcinoma (RCC) is associated with tumour recurrence.

PATIENTS AND METHODS: In all, 121 patients had nephron-sparing surgery for non-metastatic RCC for elective (85 cases) and imperative (36 cases) indications. Intraoperative frozen sections were routinely obtained and revealed negative margins in all patients. The tumour size and the shortest distance of normal parenchyma around the tumour were assessed.

RESULTS: After a mean (range) follow-up of 49.3 (12-113) months, six patients had disease progression (three with local recurrence, two of whom also had distant metastases and pure metastatic disease in three). The mean (range) width of the negative margins was 0.56 (0.1-2.3) cm. The width of the resection margin did not correlate with disease progression, while tumour size was a strong predictor of progression (P < 0.02). The mean tumour size was 5.1 cm in patients with progression and 3.1 cm in patients who remained recurrence-free.

CONCLUSIONS: Our data suggest that the width of the resection margin, unlike tumour size, does not influence the risk of tumour recurrence.