Impact of Margin Status on Survival After Radical Nephrectomy
In patients with renal cell carcinoma who underwent radical nephrectomy, positive margins were associated with earlier relapse, according to research published by Morris et al, of the University of Tennessee Health Science Center, in the Journal of Clinical Oncology. However, the investigators noted, on multivariate analysis, margin status was not a statistically significant determinant of overall or relapse-free survival at 1, 3, and 5 years.
The researchers conducted a retrospective study of 156 patients with renal cell carcinoma who had undergone radical nephrectomy at Methodist University Hospital in Memphis, Tennessee, between January 2009 and December 2013. The median duration of follow-up was 3.4 years.
Of 12 patients with positive margins, 5 (41.7%) relapsed, compared with 20 of 144 patients (13.9%) with negative margins. Among those who relapsed, there was a statistically significant difference in the time to relapse between patients with positive margins (mean, 275 days) and negative margins (mean, 621 days).
“In the current era of multiple available agents in renal cell carcinoma capable of cytoreduction, the risk factors that are predictive of a positive surgical margin at radical nephrectomy should be considered in the design of neoadjuvant systemic therapy trials, with the goal of improving long-term outcomes,” the investigators reported.