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Page 6 of 10 Mari et al. Mini-invasive Surg 2024;8:7 https://dx.doi.org/10.20517/2574-1225.2023.103

Table 2. Perioperative and pathologic characteristics of 1,611 patients treated with partial nephrectomy for RCC
Perioperative characteristics (n = 1,611)
Pedicle clamping ● Off-clamp 217 13.5%
● On-clamp 1,394 86,5%
● Warm ischemia time, median IQR 16 10-21
Surgical access ● Retroperitoneal 138 8.5%
● Transperitoneal 1,473 91.5%
SIB score ● 0-2 1,129 70.1%
● 3-4 468 29.0%
● 5 14 0.9%
Histotype ● Clear cell RCC 1,134 70.4%
● Papillary RCC 314 19.5%
● Chromophobe RCC 148 9,2%
● Unclassified RCC 2 0.1%
● Other renal tumors 175 10.9%
Pathological T stage ● pT1a 1,190 73.9%
● pT1b 496 29.1%
● pT2 31 1.9%
● pT3a 117 7.3%
Nucleolar grading G1-G4 2 2-3
Positive surgical margins 109 6.7%

RCC: Renal cell carcinoma; IQR: interquartile ranges; SIB: surface, intermediate, base.

Table 3. Multivariable analysis to predict the risk of positive surgical margins in 1611 patients treated with partial nephrectomy for
RCC
Model 1 Model 2
Variable OR 95%CI P OR 95%CI P
Imperative indication 6.06 2.58-14.22 < 0.001 6.81 2.32-17.69 < 0.001
SIB > 2 2.37 1.43-3.92 0.001 2.29 1.51-3.48 < 0.001
Off-clamp tumor resection 3.00 1.41-6.39 0.004 2.64 1.26-5.53 0.01
Age 1.01 0.99-1.02 0.14 1.01 0.98-1.02 0.28
ASA score (cont. variable) 1.11 0.82-1.50 0.47 1.64 0.78-1.62 0.54
PADUA score 1.10 1.03-1.17 0.006 - - -
Collecting system tumor compression - - - 1.34 1.09-2.84 0.001
Tumor diameter (cont. variable) - - - 1.09 0.84-1.49 0.36

RCC: Renal cell carcinoma; OR: odds ratio; SIB: surface, intermediate, base; ASA: American Society of Anesthesiologists; PADUA: preoperative
aspects and dimensions used for an anatomical.

Surgical indications allow for the classification of cases based on the necessity and background of the
surgical procedure. They range from elective, for standard cases of unilateral RCC, to imperative, in more
pressing situations such as bilateral tumors or when dealing with a solitary kidney . In the multivariable
[18]
assessment, imperative surgical indications registered a substantial OR of 6.06 (P < 0.001), underscoring its
indispensable role in shaping surgical outcomes.

The PADUA Classification, which offers a gradation system for nephrometric complexity of renal tumors, is
[19]
an instrumental determinant for surgical planning . PADUA score was significantly associated with PSMs.
This aspect has already been underscored in other multicentric cohorts , highlighting the necessity for
[20]
careful management due to the higher risk associated with complex masses. To better evaluate which