The outcomes of partial nephrectomy - considerations that contribute to positive surgical margins.

Abstract

The diagnosis in the early stages of renal tumors, as well as the oncological outcomes equivalent to extensive nephrectomies, have increased interest in partial nephrectomy (PN), which is the preferred method for treating renal cell carcinoma less than 7 cm. The literature confirms that PN offers oncological outcomes equivalent to radical nephrectomy, especially in early stages. This is a prospective study, conducted in a single university center over a period of three years, aimed to evaluate the surgical and oncological outcomes regarding positive safety margins after PN performed using laparoscopic and open approaches. Following the analysis of the causes and consequences of incomplete tumor resection, the obtained results align with data from the literature. We found that specimens from laparoscopic surgery were approximately twice as likely to have positive surgical margins compared to tumors resected using the open approach, meaning that these patients require more intense follow-up both clinically and imaging. According to current published studies, positive safety margins are not predictors for disease recurrence rate, progression-free survival, or overall survival.