title: Partial nephrectomy for renal tumors: lack of correlation between margin status and local recurrence.
abstract: OBJECTIVE
  To evaluate the relationship between a positive resection margin in partial nephrectomy (PN) and local recurrence.
  
  
  METHODS
  From January 2005 through December 2012, there were 473 PNs in 466 patients at the University of Chicago. A positive margin was defined as tumor extending to the inked specimen edge, either the parenchymal interface or the peripheral fibroadipose tissue. A local recurrence was defined as an ipsilateral tumor of identical histologic type.
  
  
  RESULTS
  Renal cell carcinoma (RCC) accounted for 406 tumors: 243 clear cell RCCs (CRCCs), 77 papillary RCCs (PRCCs), and 47 chromophobe RCCs (CHRCCs). Sixty-one RCCs had positive margins: 43 CRCCs, six PRCCs, nine CHRCCs, and three miscellaneous cell types. Of the 61 positive margins, four CRCCs (all originally multifocal) had a local recurrence, two of which occurred in the same patient. One translocation RCC also recurred. Six cases with negative resection margins had a recurrence.
  
  
  CONCLUSIONS
  A literature review of 3,803 cases, including our study, shows positive margins in 173, of which 13 recurred; however, 39 with negative margins also recurred. A positive margin in PN seldom correlates with a local recurrence. However, protection from recurrence is not ensured by a negative margin.
authors: From the Department of Pathology, University of Chicago Medicine, Chicago, IL. tatjana.antic@uchospitals.edu.
authors: Tatjana
authors: T
authors: Antic
authors: From the Department of Pathology, University of Chicago Medicine, Chicago, IL.
authors: Jerome B
authors: JB
authors: Taxy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000145:classification / Q000473:pathology / Q000601:surgery*; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000145:classification / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Local recurrence; Partial nephrectomy; Renal cell carcinoma