Local tumor bed recurrence following partial nephrectomy in patients with small renal masses
The Journal of Urology Sep 25, 2017
Wood EL, et al. - This trial entailed the inspection of the incidence, characteristics, and management of patients who had tumor bed recurrence after partial nephrectomy. A correlation was found between local tumor bed recurrence after partial nephrectomy with several preoperative factors, with the inclusion of the presence of multiple tumors and a solitary kidney, and intra/post-operative factors such as positive surgical margin and higher pathologic stage.
- The charts of 2,256 patients with sporadic small renal masses undergoing partial nephrectomy were appraised between 2000 and 2014.
- The definition of local tumor bed recurrence was either: 1) detection of a new enhancing lesion specifically within the surgical defect or 2) detection of a new enhancing lesion within the same region (e.g. lower pole) as the PN site.
- Local recurrence was noted in 44 patients (1.9%), and compared to 163 randomly selected patients who underwent PN with no recurrence for the variations in multiple characteristics.
- Patients with local tumor bed recurrence exhibited a greater tendency for solitary kidney (27% vs. 4%, p<0.01), and bilateral disease at presentation (23% vs. 10.4%, p=0.02) than the group with no recurrence.
- There appeared to be positive margins in 15.9% of local tumor bed recurrences than 3% of the control group (p<0.01).
- Median time between partial nephrectomy and detection of local tumor bed recurrence was reported as 23 months (range 2-107 months).
- A correlation was outlined between the male gender, presence of a solitary kidney at the time of partial nephrectomy, positive surgical margins, presence of multiple tumors, and higher nephrometry score and pathologic staging with local tumor bed recurrence.
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