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Background: the oncological impact of positive surgical margins (PSMs) after robot-assisted partial nephrectomy (RAPN) is still under debate.Objectives: comparing PSMs and Negative Surgical Margins (NSMs) in terms of recurrence-free survival (RFS), metastasis-free survival (MFS) and overall survival (OS) after RAPN. Evaluate the risk factors for a PSM to occur.Design, setting, and participants: ancillary study within the UroCCR database involving 26 centers. We reviewed the charts of 2673 patients who underwent RAPN between April 2010 and February 2021. Patients with benign or multiple tumors, open surgery conversion, metastasis at diagnosis (cM+) or total nephrectomy were excluded.Intervention: two groups were compared: PSM and NSM.Outcome measurements and statistical analysis: prognostic factors were assessed using, Kaplan-Meyer curves with log-Rank test, cox hazard proportional risk model and logistic regression after univariate comparison. There were 159 patients in the PSM group (6.3 %) and 2514 NSM. Median follow-up was 20 (9-38) months after RAPN. There was no difference according to age at surgery (59.5 vs 60.1, p=0,513), ASA (p=0,675), cTNM (p=0,268) , but a difference was observed for the RENAL Score (6 vs 7, p=0,034), as well as for the retroperitoneal approach (12.8% vs 6.4% p=0,008), on-clamp procedure (92.4% vs 82.8% p=0,003), warm ischemia time (21.2 vs 18.3, p |
