Positive surgical margins (PSMs) on final pathologic examination is significantly associated with adverse outcomes among patients who have undergone robotic partial nephrectomy (RPN) for kidney cancer, according to data presented at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana.

In a study of 1385 patients who underwent RPN, Sij Hemal, MD, of the Glickman Urological & Kidney Institute at Cleveland Clinic in Ohio, and colleagues found that patients with PSMs had a significantly greater incidence of pT3a pathology (30% vs 10%), lymphovascular invasion (5.7% vs 1.0%), and perirenal fat involvement (12.5% vs 3.4%) on final pathologic examination compared with those who had negative surgical margins (NSMs).

Further, patients with PSM had significantly higher rates of local recurrence (6.0% vs 2.3%) and distant metastasis (6.0% vs 2.4%) compared with those who had NSMs group. At a mean follow-up time of 51 months, the PSM group had significantly higher rates of cancer-specific (7.9% vs 1.6%) and overall mortality (18.6% vs 4.0%) compared with the NSM group.

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Of the 1385 patients, 102 had PSMs and 1283 had NSMs. Nearly 65% of patients had clear cell renal cell carcinoma.


Hemal S, Zeinab MA, Beksac T, et al. Implications of positive surgical margins following robotic partial nephrectomy. Presented at: AUA2022, May 13-16, 2022, New Orleans, Louisiana. Poster MP50-07.