Effect of surgical margin status and pathological tumor stage on tumor recurrence after open partial nephrectomy

Introduction. Th e surgical margin status and pathological tumor stage constitute important factors affecting tumor recurrence after partial nephrectomy.

Aim. To assess the role of surgical margin status and pathological tumor stage in tumor recurrence after open partial nephrectomy.

Materials and methods. Th e retrospective study included 904 kidney cancer patients who underwent open partial nephrectomy from 2010 to 2019.

Results. Renal cell carcinoma was found in 796 (88.1 %) patients. A negative surgical margin was detected in 735 (92.3 %) cases. Pathological stages were distributed as follows: pT1aN0M0 — 530 (66.6 %); pT1bN0M0 — 239 (30.0 %); pT2aN0M0 — 22 (2.8 %); pТ3aN0M0 — 5 (0.6 %). Median follow-up was 72 months. Th e recurrence rate amounted to 5.9 % (43/735) for negative surgical margins and 6.6 % (4/61) for positive surgical margins. Positive and negative surgical margins showed no significant difference in the risk of tumor recurrence (p > 0.05). Depending on the pathological stage, the following tumor recurrence rates were observed: pT1aN0M0 — 4,9 % (26/530); pT1bN0M0 — 7.5 % (18/239); pT2aN0M0 — 9.1 % (2/22); pТ3aN0M0 — 20.0 % (1/5). Th e risk of cancer recurrence was significantly higher in pT1b than in pT1a (p < 0.05), as well as in pT2 than in pT1 (p < 0.05).

Discussion. In this study, the presence of a positive surgical margin had no effect on the kidney cancer recurrence rate. However, the retrospective nature of the study and the low incidence of positive margins necessitate further study of this issue.

Conclusions. An increase in pathological tumor stage significantly affects the risk of tumor recurrence. A significant difference in recurrence rates is observed between stages T1a and T1b, as well as between stages T1 and T2.

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