Abstract

Objective

To investigate the impact of positive surgical margins (PSM) on local relapse and metastasis in patients undergoing partial nephrectomy (PN).

Materials and Methods

We retrospectively analyzed the data of 43 patients who underwent PN between June 2019 and January 2024 and met the inclusion criteria. Patients were divided into two groups: PSM and negative surgical margin (NSM). We analyzed preoperative patient characteristics, surgical details, and pathological findings. We compared the incidences of local relapse, ipsilateral radical nephrectomy, and metastasis between the two groups during follow-up.

Results

The median follow-up duration was 24.5 months in the PSM group and 16 months in the NSM group, with no significant difference in follow-up duration (p>0.05). Ischemia times were significantly longer in the PSM group (26.5 minutes vs. 18 minutes, p=0.04) and there was greater intraoperative blood loss (700 mL vs. 300 mL, p<0.001). No significant differences were observed between the groups regarding local relapse, metastasis, or ipsilateral radical nephrectomy (p>0.05). Histological type, Fuhrman grade, and pathological T-stage did not differ significantly between the groups (p>0.05).

Conclusion

PSM is associated with longer ischemia times and increased intraoperative bleeding. However, despite the higher recurrence rates associated with PSM, no statistically significant differences were observed in local relapse or metastasis when compared to NSM. Future research should focus on larger cohorts and extended follow-up to better understand the impact of surgical margins on patient outcomes.