College of Medicine (Medical School), University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Department of Hematology and Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
J Surg Oncol. 2021 Feb;123(2):687-692. doi: 10.1002/jso.26321. Epub 2020 Dec 17.
Data about the impact of surgical margin positivity on patient outcomes following radical nephrectomy (RN) for renal cell carcinoma (RCC) is limited. We evaluate the effect of positive surgical margins (PSMs) on relapse-free survival (RFS) and overall survival (OS.) METHODS: Clinicopathologic data of patients who underwent RN for RCC was analyzed based on margin status. χ and Student t test were used to compare groups. Cox regression analysis was used for the analysis. Kaplan-Meier method was used for survival curves.
A total of 485 patients who underwent RN for RCC were analyzed. Most patients with T1/T2 stage had NSM. Most patients with T4 had PSM. T3 patients were split between the two groups. Analysis of the T3 group showed shorter RFS in the PSM group at 3 years (hazard ratio [HR]: 4.3, p = .01), and 5 years (HR: 4.3, p = .01.) OS analysis showed worse OS in PSM but not statistically significant. There was a significant association between PSM and laterality (p = .023) and histologic type (p = .025.) CONCLUSIONS: PSM was associated with shorter RFS after RN in T3 RCC patients. There was a trend towards worse OS in the PSM group, but it did not reach statistical significance. Laterality and histologic type were associated with surgical margin status.
关于外科切缘阳性对肾细胞癌（RCC）根治性肾切除术（RN）后患者结局影响的数据有限。我们评估了阳性切缘（PSM）对无复发生存（RFS）和总生存（OS）的影响。
根据切缘状态分析了接受 RN 治疗 RCC 的患者的临床病理数据。χ 和学生 t 检验用于比较组。Cox 回归分析用于分析。Kaplan-Meier 法用于生存曲线。
共分析了 485 例接受 RN 治疗 RCC 的患者。大多数 T1/T2 期患者有 NSM。大多数 T4 期患者有 PSM。T3 患者分为两组。T3 组分析显示 PSM 组 RFS 较短，3 年（风险比 [HR]：4.3，p = 0.01）和 5 年（HR：4.3，p = 0.01）。OS 分析显示 PSM 组 OS 较差，但无统计学意义。PSM 与肿瘤侧别（p = 0.023）和组织学类型（p = 0.025）显著相关。
PSM 与 T3 期 RCC 患者 RN 后 RFS 缩短有关。PSM 组 OS 较差，但无统计学意义。肿瘤侧别和组织学类型与手术切缘状态有关。
