Anatomic comparison of traditional and enucleation partial nephrectomy specimens.
To compare pseudocapsule (PC) properties of clear cell renal cell carcinoma tumors removed via both traditional partial nephrectomy (PNx) and enucleative techniques as well as quantify the difference in volume of normal renal parenchyma removed between groups.



A retrospective review of clear cell PNx specimens between 2011 and 2014 was performed. All patients undergoing tumor enucleation (TE) were included. A single pathologist reviewed the pathological specimens. This cohort was compared with a previously collected clear cell traditional PNx database.



A total of 47 clear cell partial nephrectomies were reviewed (34 PNx and 13 TE). Invasion of tumor completely through the PC and positive surgical margins were seen in 2 (5.8%) and 1 (7.7%) of traditional and TE specimens, respectively (P = 0.82). PC mean (0.63 vs. 0.52mm), maximum (1.39 vs. 1.65mm), and minimum thickness (0.27 vs. 0.19mm) were similar between cohorts (P = 0.29, P = 0.36, and P = 0.44). Gross specimen volume varied considerably between the 2 groups (35.6 vs. 17.9cm3, P≤0.05) although tumor volume did not (12 vs. 14.2cm3, P = 0.64). The renal tumor consisted of only 37% of the total volume of the traditional PNx specimens compared to 80% of the volume in TEs (P<0.01). Four TE specimens (31%) were "true" TEs (no additional parenchyma identified outside of the PC).



PC properties appear independent of surgical technique. True TEs are uncommon. Regardless, there is considerable volume discrepancy of normal renal parenchymal removed between enucleative and nonenucleative PNx groups.
Department of Urology, Indiana University School of Medicine, Indianapolis, IN.
Adam C
AC
Calaway
Department of Pathology, Indiana University School of Medicine, Indianapolis, IN.
Dibson D
DD
Gondim
Department of Urology, Indiana University School of Medicine, Indianapolis, IN.
Chandra K
CK
Flack
Department of Urology, Indiana University School of Medicine, Indianapolis, IN.
Joseph M
JM
Jacob
Department of Pathology, Indiana University School of Medicine, Indianapolis, IN.
Muhammad T
MT
Idrees
Department of Urology, Indiana University School of Medicine, Indianapolis, IN. Electronic address: rboris@iupui.edu.
Ronald S
RS
Boris
D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery; D000072662:Margins of Excision; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual; D009392:Nephrectomy / Q000379:methods*; D059351:Organ Sparing Treatments; D000072356:Parenchymal Tissue / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies
Clear cell renal cell carcinoma; Traditional partial nephrectomy; Tumor enucleation; Tumor pseudocapsule