Dec 31, 2012 - 3:20 pm
I have heard alot about clear, negative and positive margins. In my case, I did not have clear margins and yet the doctor professed he got it all and is positive that there is a low level of risk for recurrence. In fact, with stage 1 (localized and less than 4cm), he states that he favours doing nehpron sparing surgery (NSS) with minimal or no margins.
This appears to contridict what I had heard about margins on this site and in other research, however, knowing that stats and research can become outdated quickly with RCC and that I have a lot of faith in my surgeon, I looked for literature to better understand the current thinking on margins. I found many recent articles on margins, but this one appears to be simple to understand and highlights more recent thinking for Mini-margins and nephron sparing suregries (=partial nephrectomy).
The article concludes that " Mini-margin NSS is as safe and effective as 1cm-NSS and RN (radical nephrectomy) in treating early localized RCC 4cm or less. It provides excellent renal function preservation, favorable long-term progression-free survival, lower complication rate, and is not associated with an increased risk of local recurrence."