Ces Urol X:X | DOI: 10.48095/cccu2025016
Positive surgical margins in renal malignancies after nephron-sparing surgery – results of a single-centre retrospective analysis
- Urologická klinika 3. LF UK a FN Královské Vinohrady, Praha
Objective: The aim of this study was to compare the incidence of positive surgical margins (PSM) in nephron-sparing surgeries on the kidneys, postoperative follow-up, and complications in patients at our institution with global trends.
Material and methods: The analysis was conducted on a set of procedures performed at the Urology clinic of University Hospital Královské Vinohrady from 2011 to 2021.
Results: During the analyzed period, a total of 611 nephron-sparing surgeries were performed at our clinic. Of these, 117 patients underwent laparoscopic partial nephrectomy (LPN) and 494 patients underwent open partial nephrectomy (OPN). Among the patients who underwent OPN, malignant histology was confirmed in 336 cases, with PSM observed in 21 patients (6.25%). In the LPN group, malignant histology was confirmed in 81 cases, with PSM found in 6 patients (7.4%). Another subgroup consisted of patients with uncertain surgical margins. Overall, in the cohort of patients who underwent OPN, this type of surgical margin was observed in 16 cases (4.7%), while in the LPN group, it was observed in 6 cases (7.4%). Local recurrence occurred in 5 cases and metastasis in 4 cases in the OPN group. In patients who underwent LPN with confirmed PSM, no cases of recurrence or metastasis were observed.
Conclusion: This research confirms alignment with the overall trend in several key aspects. The incidence of positive surgical margins in nephron-sparing surgeries on the kidneys corresponds to the values reported in the literature and confirms that positive surgical margins rarely lead to disease relapse.
Keywords: positive surgical margins – nephron-sparing surgery – kidneys – postoperative follow-up – outcomes
Received: December 8, 2024; Revised: June 3, 2025; Accepted: June 13, 2025; Prepublished online: August 21, 2025
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