Optimal Surgical Margin in Nephron-sparing Surgery

                OBJECTIVE To determine the optimal surgical margins in nephron-sparing surgery (NSS) for T1b renal cell
carcinomas (RCC).
MATERIALS AND
METHODS
We retrospectively assessed 87 T1b RCC specimens after radical nephrectomy through wholekidney
continuous sections, with 92 T1a RCCs included as controls. The completeness of天津医科大学肿瘤医院泌尿肿瘤科杜君
pseudocapsule (PS) and extra-PS lesions and multifocality were microscopically examined, as was
the greatest distance between extra-PS lesions and primary tumors.
RESULTS The rates of incomplete PS (34% [30/87] vs 18% [17/92], P  .015) and positive cancer lesions
beyond the PS (39% [34/87] vs 25% [23/92], P  .043) were significantly higher in the T1b than
in the T1a group. All extra-PS lesions were located within 3.0 mm of the primary tumor.
Multifocal tumors were found in 6% (5/87) of patients with T1b and 5% (5/92) of patients with
T1a tumors (P  .928).
CONCLUSION These results indicate that 4 mm may be the optimal surgical margin for NSS for patients with
T1b RCC because all extra-PS lesions were located within 3 mm of the primary
tumors.