We examined the impact of positive vascular margins in patients with pT3 clear cell renal cell carcinoma.
After excluding patients with non-vascular positive margins, metastasis, lymph node involvement, neoadjuvant therapy, or non-clear cell histology, we identified 224 patients with venous tumor invasion through our institutional database from 1999-2013.
Kaplan-Meier analysis and log rank tests were used to evaluate whether positive vascular margins were associated with progression-free survival or cancer-specific survival.
Forty-one patients (18%) had a positive vascular margin. Margin status was directly related to the level of invasion (p
In patients with pT3N0/XM0 clear cell renal cell carcinoma, positive vascular margins are associated with risk for disease progression. However, the risk of relapse associated with positive vascular margin is driven by extent of vascular thrombus invasion. These findings suggest that the clinical significance of vascular margin status as currently defined in pT3 clear cell renal cell carcinoma is minimal.
The Journal of urology. 2015 Sep 09 [Epub ahead of print]
Nick W Liu, James D Wren, Emily Vertosick, Justin K Lee, Nicholas E Power, Nicole E Benfante, Simon Y Kimm, Manjit S Bains, Daniel D Sjoberg, Paul Russo, Jonathan A Coleman
Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA. , Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.