ABSTRACT
We systematically evaluated the impact of positive surgical margins (PSM) on oncological
outcomes after partial nephrectomy for renal cell carcinoma. Forty-two studies comprising
101,153 subjects were included and five distinct meta-analyses were performed. PSM
was associated with increased risk of local recurrence (hazard ratio (HR) 6.11—high
certainty), metastasis (HR 3.29—moderate certainty), overall relapse (HR 2.25—high
certainty), overall mortality (HR 1.30—moderate certainty), and may be associated
with increased cancer-specific mortality (HR 1.91—low certainty). Patients with PSM
should be counseled for the possibility of additional surgery, novel adjuvant therapies,
and more rigorous surveillance.
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Article info
Publication history
Published online: June 26, 2021
Accepted:
April 14,
2021
Received:
January 9,
2021
Footnotes
Funding supports: None.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
