Campi, R.

Carini, Marco

Kutikov, A.

Lapini, A.

Mari, A.

Minervini, Andrea

Montagnani, I.

Raspollini, M. R.

Smaldone, M.

Uzzo, R.

English

Florence Research

864 Beyond the complexity of tumour excision during partial nephrectomy: Ideation andhistopathological validation of the Surface-Intermediate-Base (SIB) margin score Eur Urol Suppl 2016;15(3);e864          Print!Minervini A.1, Campi R.1, Raspollini M.R.2, Montagnani I.2, Mari A.1, Smaldone M.3, Uzzo R.3, Lapini A.1, Carini M.1, Kutikov A.41University of Florence, Careggi Hospital, Dept. of Urology, Florence, Italy, 2University of Florence, Careggi Hospital, Dept. of Pathology,Florence, Italy, 3Fox Chase Cancer Center, Division of Urologic Oncology, Philadelphia, United States of America, 4Fox Chase CancerCenterogic Oncology, Division of Urologic Oncology, Philadelphia, United States of AmericaINTRODUCTION & OBJECTIVES: Tumour excision is a fundamental step during Partial Nephrectomy (PN), yet Resection Technique (RT)is rarely reported in current Nephron Sparing Surgery (NSS) literature. We recently proposed the Surface-Intermediate-Base (SIB) Marginscore as a new classification model for standardized reporting of RT during NSS. The aim of the study is to validate the SIB model from ahistopathological perspective.MATERIAL & METHODS: Data were prospectively collected from a cohort of 40 patients undergoing NSS between June and September2014 at a single Institution. The SIB score was assigned in the operating room by the surgeon. The Score Specific Areas (SSA) wereoutlined on a digital picture as anatomic landmarks for histopathological analysis. Two dedicated uropathologists inked the landmark areasand measured, in a blinded fashion, the maximum, minimum and mean thickness of Healthy Renal Margin (HRM) within the SSAs (360overall histologic measures, Fig.1). The Mann-Whitney U-test was used to assess the correlation between the SIB visual definitions of RTsand the thickness of HRM at histopathological analysis.RESULTS: The overall RT was classified as pure enucleation, hybrid enucleation and pure enucleoresection in 28 (70%), 7 (17%), 3 (7%)patients, respectively, while as hybrid enucleoresection and resection in 1(3%) patient each. At histopathological analysis, the maximum,minimum and mean thickness of HRM was significantly different among SSAs visually defined as enucleation (S=0: median 0,18mm (IQR0,08-0,30), I or B = 0: median 0,20 mm (IQR 0,08-0,36)), enucleoresection (S=1: median 0,80mm (IQR 0,67-1,16),I, B = 1: median 0,88mm (IQR 0,60-1,00)) and resection (S =1, I,B =2: median 2,95 mm (IQR 2,18-5,75) (Fig. 2) (p <0.001).CONCLUSIONS: The SIB Margin score is the first standardized reporting system to communicate RT during NSS.Our study has proved the applicability of the model in a real-world clinical setting and provided robust histopathological validation of itsutility. 

Beyond the complexity of tumour excision during partial nephrectomy: Ideation and

histopathological validation of the Surface-Intermediate-Base (SIB) margin score

https://flore.unifi.it/bitstream/2158/1056739/1/864-Beyond-the-complexity-of-tumour-excision-during-partial-nephrectomy-Ideation-and-histopathological-validation-of-the-Surface-Intermediate-Base-SIB%20-%20Copia.pdf

Beyond the complexity of tumour excision during partial nephrectomy: Ideation and histopathological validation of the Surface-Intermediate-Base (SIB) margin score

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