Oncologic Impact of Renal Tissue Adjacent to Renal Cell Carcinoma.
OBJECTIVE
The aim of the study was to investigate the clinical impact of the surgical margin width after nephron-sparing surgery (NSS) on the oncological course of renal cell carcinoma (RCC).


METHODS
The study comprised of 126 RCC patients with NSS between 2002 and 2009. Inclusion criteria were negative resection margins and a tumor diameter of ≤100 mm with the possibility of a complete circumferential histopathological reevaluation. The minimal benign margin width was correlated to the patients' clinical course.


RESULTS
Median safety margin width was revealed to be 1 mm. Nine of 126 patients (7.1%) developed recurrent disease (five local, four distant). All patients with local recurrence had safety margins ≤1 mm, whereas out of 49 patients with a margin >1 mm no one developed local recurrence (p=0.0245). Safety margin ≤1 mm showed associations with increased risk for overall recurrence in univariate and multivariate analysis (p=0.0531 and 0.0539, respectively).


CONCLUSIONS
Tumor adjacent renal parenchyma may have oncological relevance, corroborating the need for further molecular investigation of tumor-adjacent tissue in RCC.
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Stefan
S
Aufderklamm
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Jörg
J
Hennenlotter
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Tilman
T
Todenhöfer
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Nicolas
N
Senghaas
Department of Pathology, Eberhard Karls University Tübingen, Tübingen, Germany.
Marcus
M
Scharpf
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Georgios
G
Gakis
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Steffen
S
Rausch
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Johannes
J
Mischinger
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Simone
S
Bier
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany.
Arnulf
A
Stenzl
Department of Urology, Diakonie Klinikum Stuttgart, Stuttgart, Germany.
Christian
C
Schwentner
Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany jens.bedke@med.uni-tuebingen.de.
Jens
J
Bedke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009399:Nephrons / Q000601:surgery*
Renal cell carcinoma; nephron-sparing surgery; oncological outcome; parenchyma; recurrence; safety margin