CSN Login
Members Online: 7

You are here

Relevance of negative margins in a full nephrectomy

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

Hi everyone, 

I was just wondering something: When a full nephrectomy occurs, what determines "positive" or "negative" margins? Perhaps I just don't understand the concept, but how is this determined if the entire kidney is removed? And, what, if any,  is the benefit of "negative margins" on a radical neprectoamy if the tumor is staged based on invasion of areas (eg., renal sinus, renal vein, etc)

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

Hope this helps.  http://www.cancer.gov/dictionary?cdrid=44531

Ron

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

I guess that is where I get confused: I see how "negative margins" apply to a partial (some tumor out, rest of kidney remains) but what exactly are the margins when a kidney comes out with a tumor, and the tumor as "extended" beyond the kidney? What part of the tumor is being biopsied to get negative margins when the tumor extends into the perenepthretic fat?

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

Sadly no, it means that there is a chance that some cells are circulating. You need proper follow up, at three or four month intervals. This includes CT Scans of the chest, abdomen and pelvis, with Contrast if possible.

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

Yes, that's what I thought. So mentioning "negative margins" in a pathology report on a full nephrectomy tumor, say Stage T3A like my husbands is really meaningless? 
THANKS SO MUCH RON!!!!

a_oaklee
Posts: 519
Joined: Nov 2013

Negative margins are very good.  I would always want negative margins on anything removed.  In fact, I would want surgery again in order to get negative margins. 

Are negative margins a guarantee that a person doesn't have cells floating around in their body somewhere?  I would say no.  But it does NOT mean that having some miniscule cancer cells floating around will actually turn into anything.  A persons own immune system can handle rogue cells (possibly). 

A pathologist gets a specimen from the operating room.  Sometimes multiple labeled specimens.  The pathologist takes a bunch of slices from different sections of the sample.  They put it in wax and process it.  Make really tiny slices and put those on glass slides, and process, and then read it with a microscope.  Sometimes they go back and make more slices, or more slides, or process it differently, or get a consult, etc..  On our report there are multiple margins mentioned.  The margin refers to the edge of whatever they are talking about.  My husband had a complete nephrectomy.  The tumor was encapsulated inside the kidney.  They mentioned the edges of the gross specimen (big blob).  They mentioned the margin of the kidney cortex.  They mentioned the edge of the tumor and where it was.  They mentioned the margins of the blood vessels.  He had a tumor thrombus in the inferior vena cava.  They mentioned the margins of the vena cava wall and the thrombus.  Perinephric fat (fat that got cut out around the kidney) also got mentioned.  There would be margins there too. 

My husbands margins were all clear.  He was diagnosed as Stage 4 because he had mets to bones and one lymph node.  Obviously the tumor cells developed or traveled through the lymph system and blood vessels.  We are still very happy with the clear margins.  He doesn't have any cancer left in that region (at the present time).  That's a good thing. 

I say "celebrate" whatever you can.  Clear margins!  Yeah!

Annie

 

 

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

This was helpful, thanks. We only got "negative" in our report so I wasn't sure exactlly what was being referred to when it said that. Also, our tumor was not encapsulated, therefore tha was why I was confused about what exactly they report was referring to when it said "negative" 

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

And I just re-read the history you posted.. T3 Chromophobe..  yes, follow up is very important..  There are some postings here of people with Chromophobe.. you may wish to do a search and see what they had to say..

Good Luck..

Ron

Subscribe to Comments for "Relevance of negative margins in a full nephrectomy"