Does a Positive Surgical Margin After Nephron Sparing Surgery Affect Oncological Outcome in Renal Cell Carcinoma? A Systematic Review and Meta-analysis

被引：16

作者：

Hakam, Nizar

Abou Heidar, Nassib

Khabsa, Joanne

Hneiny, Layal

Akl, Elie A.

Khauli, Raja ^{[1
]}

机构：

[1] Amer Univ Beirut, Med Ctr, Dept Surg, Div Urol & Renal Transplantat, POB 11-0236 Riad Solh 1107 2020, Beirut, Lebanon

来源：

UROLOGY | 2021年 / 156卷

关键词：

PARTIAL NEPHRECTOMY; SURVIVAL; CANCER; RECURRENCE; GUIDELINES; MANAGEMENT; INCREASE; TRENDS; GRADE; RISK;

D O I：

10.1016/j.urology.2021.04.058

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

We systematically evaluated the impact of positive surgical margins (PSM) on oncological outcomes after partial nephrectomy for renal cell carcinoma. Forty-two studies comprising 101,153 subjects were included and five distinct meta-analyses were performed. PSM was associated with increased risk of local recurrence (hazard ratio (HR) 6.11-high certainty), metastasis (HR 3.29-moderate certainty), overall relapse (HR 2.25-high certainty), overall mortality (HR 1.30-moderate certainty), and may be associated with increased cancer-specific mortality (HR 1.91-low certainty). Patients with PSM should be counseled for the possibility of additional surgery, novel adjuvant therapies, and more rigorous surveillance. (C) 2021 Elsevier Inc.

引用

页码：E30 / E38

页数：9

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