Oncological Results After Accidental Tumor Incision During Partial Nephrectomy.
Markus Varpela1, Sara Tornberg1, Harry Nisen1
1Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
European Urology Open Science
|December 3, 2025
Summary
Accidental tumor incision during partial nephrectomy for renal cell carcinoma (RCC) increases recurrence risk. While cancer-specific survival was not significantly different, careful surgical technique and extended surveillance are recommended for patients with accidental tumor incision (ATI).
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Accidental tumor incision (ATI) during partial nephrectomy (PN) for renal cell carcinoma (RCC) is an adverse event.
- Understanding the oncological outcomes of ATI is crucial for patient management.
Purpose of the Study:
- To examine oncological outcomes, specifically recurrence-free survival (RFS) and cancer-specific survival (CSS), in patients with ATI during PN for cT1 RCC.
Main Methods:
- Retrospective single-center study of 813 patients undergoing PN for cT1a-b RCC.
- Patients were divided into groups with and without ATI.
- Kaplan-Meier method and log-rank test were used to compare RFS and CSS.
Main Results:
- ATI occurred in 103 patients (13%).
- RFS was significantly lower in the ATI group (p < 0.001) over a median follow-up of 52 months.
- No significant difference in CSS was observed between groups (p = 0.8).
- ATI was associated with larger tumor diameter and higher RENAL score.
Conclusions:
- ATI during PN for T1 RCC is linked to a higher risk of disease recurrence.
- While CSS was not significantly different in the intermediate follow-up, clinicians should minimize ATI and consider extended surveillance for affected patients.
- Further research is needed on preventative strategies and long-term survival impacts.
