Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü

Translated title of the contribution: Recurrence after nephron sparing surgery and the role of intra-operative frozen-section analysis

Tolga Akman, Öner Şanli, Tarik Esen, Murat Tunç, Faruk Özcan, Işin Kiliçaslan

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction: Partial nephrectomy is being performed more frequently for small, incidentally discovered, low-stage renal tumors. The main advantage of partial nephrectomy is the avoidance of renal insufficiency. The aim of this study is to analyze the outcome of patients who have undergone nephron sparing surgery in our clinic and question the clinical role of intra-operative frozen-section analysis for determining the negative surgical margins. Materials and Methods: Forty-five patients who underwent nephron-sparing surgery between 1997 and 2006 with complete follow-up data available were included to the study. Of these patients, 42 had NSS, while 3 had radical nephrectomy because of the positive surgical margins in frozen section analysis. Indication for nephron-sparing surgery was absolute in 9.6% and elective in 90.4% of the patients. Clinical characteristics, operative findings, pathologic results and follow-up data of these patients were retrospectively analyzed. Results: The mean age and mean tumor size of the 42 patients with NSS were 51.5±12.5 (range: 24-76) years and 3.79±1.6 (2-10) cm, respectively. Histopathological analysis revealed renal cell carcinoma (RCC), oncocytoma and angiomyolipoma in 69% (n: 29), 19% (n: 8) and 11.9% (n: 5) of the patients, respectively. No significant intraoperative complication occurred. Among RCC patients, 65.5% had clear cell, 20.6% had papillary, 10.3% had chromopobe and 3.4% had eosinophilic histologic subtype. Fuhrman nuclear grade of 1, 2, 3 and 4 was evident in 1 (%3.4), 22 (%75.8), 5 (%17.2) and 1 (%3.4) patient, respectively. After a mean follow-up period of 26.0±21.6 (2-84) months, 2 (7.4%) out of 27 RCC patients had experienced recurrent disease. Conclusion: In the present study, recurrence rate after nephron-sparing surgery was found to be 7.4% which is quite similar to the literature. However, predictive factors for recurrent disease could not be determined due to the limited number of patients. Despite its reliability for determining the negative surgical margins, frozen section analysis has no impact on local recurrence and distant metastasis. For this reason, the routine use of frozen section analysis should be questioned in the light of the more extensive studies.

Original languageTurkish
Pages (from-to)309-314
Number of pages6
JournalTurk Uroloji Dergisi
Volume32
Issue number3
StatePublished - Sep 1 2006

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Nephrons
Frozen Sections
Recurrence
Nephrectomy
Renal Cell Carcinoma
Oxyphilic Adenoma
Angiomyolipoma
Intraoperative Complications
Renal Insufficiency
Neoplasms
Neoplasm Metastasis
Kidney

Keywords

  • Histopathology
  • Prognosis
  • Recurrence
  • Renal tumor

ASJC Scopus subject areas

  • Urology

Cite this

Akman, T., Şanli, Ö., Esen, T., Tunç, M., Özcan, F., & Kiliçaslan, I. (2006). Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü. Turk Uroloji Dergisi, 32(3), 309-314.

Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü. / Akman, Tolga; Şanli, Öner; Esen, Tarik; Tunç, Murat; Özcan, Faruk; Kiliçaslan, Işin.

In: Turk Uroloji Dergisi, Vol. 32, No. 3, 01.09.2006, p. 309-314.

Research output: Contribution to journalArticle

Akman, T, Şanli, Ö, Esen, T, Tunç, M, Özcan, F & Kiliçaslan, I 2006, 'Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü', Turk Uroloji Dergisi, vol. 32, no. 3, pp. 309-314.
Akman T, Şanli Ö, Esen T, Tunç M, Özcan F, Kiliçaslan I. Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü. Turk Uroloji Dergisi. 2006 Sep 1;32(3):309-314.
Akman, Tolga ; Şanli, Öner ; Esen, Tarik ; Tunç, Murat ; Özcan, Faruk ; Kiliçaslan, Işin. / Nefron koruyucu cerrahi sonrasi nüks ve ameliyat sirasinda frozen kesit analizinin rolü. In: Turk Uroloji Dergisi. 2006 ; Vol. 32, No. 3. pp. 309-314.
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abstract = "Introduction: Partial nephrectomy is being performed more frequently for small, incidentally discovered, low-stage renal tumors. The main advantage of partial nephrectomy is the avoidance of renal insufficiency. The aim of this study is to analyze the outcome of patients who have undergone nephron sparing surgery in our clinic and question the clinical role of intra-operative frozen-section analysis for determining the negative surgical margins. Materials and Methods: Forty-five patients who underwent nephron-sparing surgery between 1997 and 2006 with complete follow-up data available were included to the study. Of these patients, 42 had NSS, while 3 had radical nephrectomy because of the positive surgical margins in frozen section analysis. Indication for nephron-sparing surgery was absolute in 9.6{\%} and elective in 90.4{\%} of the patients. Clinical characteristics, operative findings, pathologic results and follow-up data of these patients were retrospectively analyzed. Results: The mean age and mean tumor size of the 42 patients with NSS were 51.5±12.5 (range: 24-76) years and 3.79±1.6 (2-10) cm, respectively. Histopathological analysis revealed renal cell carcinoma (RCC), oncocytoma and angiomyolipoma in 69{\%} (n: 29), 19{\%} (n: 8) and 11.9{\%} (n: 5) of the patients, respectively. No significant intraoperative complication occurred. Among RCC patients, 65.5{\%} had clear cell, 20.6{\%} had papillary, 10.3{\%} had chromopobe and 3.4{\%} had eosinophilic histologic subtype. Fuhrman nuclear grade of 1, 2, 3 and 4 was evident in 1 ({\%}3.4), 22 ({\%}75.8), 5 ({\%}17.2) and 1 ({\%}3.4) patient, respectively. After a mean follow-up period of 26.0±21.6 (2-84) months, 2 (7.4{\%}) out of 27 RCC patients had experienced recurrent disease. Conclusion: In the present study, recurrence rate after nephron-sparing surgery was found to be 7.4{\%} which is quite similar to the literature. However, predictive factors for recurrent disease could not be determined due to the limited number of patients. Despite its reliability for determining the negative surgical margins, frozen section analysis has no impact on local recurrence and distant metastasis. For this reason, the routine use of frozen section analysis should be questioned in the light of the more extensive studies.",
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N2 - Introduction: Partial nephrectomy is being performed more frequently for small, incidentally discovered, low-stage renal tumors. The main advantage of partial nephrectomy is the avoidance of renal insufficiency. The aim of this study is to analyze the outcome of patients who have undergone nephron sparing surgery in our clinic and question the clinical role of intra-operative frozen-section analysis for determining the negative surgical margins. Materials and Methods: Forty-five patients who underwent nephron-sparing surgery between 1997 and 2006 with complete follow-up data available were included to the study. Of these patients, 42 had NSS, while 3 had radical nephrectomy because of the positive surgical margins in frozen section analysis. Indication for nephron-sparing surgery was absolute in 9.6% and elective in 90.4% of the patients. Clinical characteristics, operative findings, pathologic results and follow-up data of these patients were retrospectively analyzed. Results: The mean age and mean tumor size of the 42 patients with NSS were 51.5±12.5 (range: 24-76) years and 3.79±1.6 (2-10) cm, respectively. Histopathological analysis revealed renal cell carcinoma (RCC), oncocytoma and angiomyolipoma in 69% (n: 29), 19% (n: 8) and 11.9% (n: 5) of the patients, respectively. No significant intraoperative complication occurred. Among RCC patients, 65.5% had clear cell, 20.6% had papillary, 10.3% had chromopobe and 3.4% had eosinophilic histologic subtype. Fuhrman nuclear grade of 1, 2, 3 and 4 was evident in 1 (%3.4), 22 (%75.8), 5 (%17.2) and 1 (%3.4) patient, respectively. After a mean follow-up period of 26.0±21.6 (2-84) months, 2 (7.4%) out of 27 RCC patients had experienced recurrent disease. Conclusion: In the present study, recurrence rate after nephron-sparing surgery was found to be 7.4% which is quite similar to the literature. However, predictive factors for recurrent disease could not be determined due to the limited number of patients. Despite its reliability for determining the negative surgical margins, frozen section analysis has no impact on local recurrence and distant metastasis. For this reason, the routine use of frozen section analysis should be questioned in the light of the more extensive studies.

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