Long-term consequences of positive surgical margin after partial nephrectomy for renal cell carcinoma: multi‐institutional analysis

Introduction The aim of the study was to determine the impact of positive surgical margins (PSM) after PN on very long-term recurrence in a contemporary cohort. Methods Patients who underwent PN for a localized renal tumour were included. Patients were stratified according to the presence of PSM. Data on patients’ characteristics, the tumour, the peri- and postoperative events were collected. Disease-free survival (DFS) and overall survival (OS) were assessed by the Kaplan–Meier method and compared by the log-rank test. Sensitivity analyses using weighted propensity score analysis was performed to account for potential selection biases arising from the nonrandom allocation of patients to different groups. Results A total of 1115 patients were included in the study. The incidence of PSM was 5.4% ( n = 61). The median follow-up time was 51 months for the PSM group and 61 months for the NSM group ( p = 0.31). Recurrence rates were significantly higher in the PSM group (13%, n = 8) compared to the NSM group (7%, n = 73) ( p = 0.05). This resulted in a significant reduction in DFS in the PSM group ( p = 0.004), particularly pronounced in patients with clear cell renal cell carcinoma. Additionally, OS was significantly lower in the PSM group ( p