The Prognostic Value of the Width of the Surgical Margin in the Enucleoresection of Small Renal Cell Carcinoma: An Intermediate-term Follow-up

Objectives To assess the prognostic value of the width of a healthy surgical margin in the enucleoresection of small renal cell carcinoma, in which 68% of cases had a margin width of 3.0 mm or less. Methods We retrospectively reviewed 98 consecutive enucleoresections regarding the width of healthy margin and tumor recurrence in 96 patients followed up for more than 3 years after surgery. The mean follow-up was 70.8 months. Results The mean tumor size was 2.8 cm (range, 1.0-6.1). Three cases had a positive surgical margin, and 2 of them had positive frozen biopsy results with additional negative biopsies. The other case did not have a frozen biopsy and did not show any evidence of recurrence during follow-up. The mean width of the surgical margin of the remaining 95 enucleoresections was 2.9 mm (0.5-15.0): 26.3% were 1 mm or less, 42.1% were 1.1-3.0 mm, 23.2% were 3.1-5.0 mm, and 8.4% were 5.1 mm or more. Only 1 patient developed tumor recurrence during follow-up, excluding a patient with von Hippel Lindau disease. This patient with a 2-mm width healthy margin but capsular invasion had enlarged abdominal lymph nodes at 38 months of follow-up. Conclusions The width of the surgical margin was not associated with the oncological prognosis in our enucleoresection series of small renal cell carcinoma, in which the width of the margin was 3.0 mm or less in more than two-thirds of the cases.