Related Experiment Video
Updated: Dec 29, 2025
04:45
Intraoperative Assessment of Resection Margins in Oral Cavity Cancer: This is the Way
Published on: May 10, 2021
4.3K
Predicting positive surgical margins in partial nephrectomy: A prospective multicentre observational study (the
Riccardo Schiavina1, Andrea Mari2, Lorenzo Bianchi1
1Department of Urology, University of Bologna, Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy.
Summary
Positive surgical margins after partial nephrectomy are predicted by clinical stage, surgical technique, and center volume. A new nomogram helps predict this risk in patients undergoing renal tumor treatment.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Renal tumors are common, and partial nephrectomy (PN) is a standard treatment.
- Positive surgical margins (PSMs) can impact oncological outcomes.
- Predicting PSMs is crucial for surgical planning and patient counseling.
Purpose of the Study:
- To identify clinical predictors of PSMs following PN.
- To develop a nomogram for predicting PSMs in a large, multicenter cohort.
- To evaluate the impact of center volume on PSM rates.
Main Methods:
- Prospective observational study of 4308 patients with renal tumors across 26 Italian centers (RECORd 2 project).
- Analysis focused on 2076 patients who underwent PN.
- Multivariable logistic regression models were used to identify PSM predictors; a nomogram was developed.
Main Results:
- PSMs were identified in 16.5% of PN cases.
- Independent predictors of PSMs included clinical stage (cT2), lower center volume (≤60 PN/year), imperative indication, laparoscopic technique, lymphovascular invasion, and upstaging to pT3a.
- The final nomogram incorporated age, ASA score, Charlson score, clinical tumor stage, surgical indication, surgical approach, surgical technique, PADUA score, clamp procedure, and center volume.
Conclusions:
- PSMs after PN are associated with lower clinical stage, higher PADUA score, laparoscopic approach, and lower-volume centers.
- The developed nomogram provides a tool to predict the risk of PSMs.
- These findings aid in refining surgical strategies and patient selection for PN.
