Determination of the Safe Surgical Margin for T1b Renal Cell Carcinoma

被引:0
作者
Zhang, Kan [1 ]
Xie, Wen Lian [1 ]
机构
[1] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Peoples R China
关键词
renal cell carcinoma; partial nephrectomy; distance of extra-pseudocapsule lesion; satellite tumours; safe surgical margin; NEPHRON-SPARING SURGERY; OPEN PARTIAL NEPHRECTOMY; RADICAL NEPHRECTOMY; 4; CM; ENUCLEATION; GUIDELINES; OUTCOMES; TUMORS;
D O I
暂无
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
Purpose: To determine the rational surgical margin for pathological Tlb renal cell carcinoma (RCC). Materials and Methods: This retrospective study included surveys of 60 patients with T1bNOMO RCC who underwent radical nephrectomy (RN, n = 40) or partial nephrectomy (PN, n = 20) between October 2008 and December 2014 at the Sun Yat-sen Memorial Hospital affiliated with Zhongshan University. Specimens were collected from 6 sites at the tumour periphery for RN and PN, and at suspected sites on the tumour surface for PN in addition. The histological subtype, pathological grade, surgical margin, pseudocapsule completeness, distribution of satellite foci, and largest distance between the extra-pseudocapsule lesion and primary tumour (DEP) were evaluated. This paper will analyse the relationships between these factors. Results: The positive surgical margin rate was 10% in patients undergoing PN. The study found no significant relationships between the incidence of satellite foci and tumour diameter, Fuhrman grade, or histological subtype (all P > 0.05). However, male sex, positive surgical margins, and an incomplete pseudocapsule were associated with the incidence of satellite foci (P < 0.05). Cases with satellite foci tended to show positive surgical margins. The DEP was <1.0 mm for all tumours, but there were no significant relationships between the DEP and the tumour diameter, pathological grade, or histological subtype (P > 0.05). Conclusion: In Tlb RCC, a 1-mm surgical margin would be sufficient to attain integrated resection of the primary tumour and its cancerous tissue beyond the pseudocapsule. PN was insufficient to prevent a positive surgical margin, most likely due to the presence of satellite foci.
引用
收藏
页码:2961 / 2967
页数:7
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