On Cox multiple regression analysis, a higher risk of all-cause mortality was associated with positive surgical margins (HR 1.39, p = 0.001), older age, CCI equal to or greater than two (HR 2.384, p < 0.001), and tumor size greater than four cm. A lower risk of all-cause mortality was associated with chromophobe histology (HR 0.341, p < 0.001).
These authors are to be commended for addressing the controversial issue of the impact of surgical margins status on survival after partial nephrectomy. However, there are obvious limitations to using the NCDB. The most relevant here is the absence of data on cancer-specific survival and local recurrence rate.
Presented by: Cheuk Fan Shum
Authors: Cheuk Fan Shum, Clinton D. Bahler, and Chandru P. Sundaram – Indiana University School of Medicine, Indianapolis, IN
Written by: Michael Owyong (@ohyoungmike), LIFT Fellow, Department of Urology, UC Irvine Medical Center, Orange, CA at the 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.