Outcomes of renal cell carcinoma with associated venous tumor thrombus: experience from a large cohort and short time span in a single center

BMC Cancer

Xiaojun Tian¹  Zhuo Liu¹  Liyuan Ge¹  Lulin Ma¹  Min Qiu¹  Cheng Liu¹  Shudong Zhang¹  Feilong Yang²  Zhigang Chen³ 

[1] Department of Urology, Peking University Third Hospital, 100191, Beijing, China;Department of Urology, Peking University Third Hospital, 100191, Beijing, China;Department of Urology, General Hospital of Ningxia Medical University, 750004, Yinchuan, China;Peking University Health Science Centre, No.49 North Garden Road, Haidian District, Beijing, P. R. China;Department of Urology, Peking University Third Hospital, 100191, Beijing, China;

关键词: Renal cell carcinoma;    Venous tumor thrombus;    Thrombectomy;    Overall survival;    Prognosis;   

DOI  :  10.1186/s12885-021-08508-x

来源: Springer

【 摘 要 】

BackgroundThe surgical management and outcomes of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) have been reported in limited sample size, and there remain discrepancies over the factors that influence oncologic outcomes after radical nephrectomy with thrombectomy (RNTE). The aim of the study was to analyze the outcomes of the patients with RCC with VTT in our institution and identify the independent prognostic factors.MethodsPatients with RCC with VTT were enrolled for the study from February 2015 to December 2018. All patients underwent RNTE. Clinical data were compared using Mann-Whitney U test and the chi-square test for continuous and categorical variables respectively. Survival analysis was estimated using the Kaplan-Meier method. Univariable and multivariable survival analyses were performed using Cox regression model.Results121 patients (91 men & 30 women) were identified with a median age of 60 years. VTT level was 0 in 25 patients, I in 20, II in 50, III in 12 and IV in 14. The median follow-up time was 24 months. During the follow-up period, 51 (42%) patients died and 69 (57%) patients experienced recurrence or metastasis. The 3-year and 5-year over-all survival (OS) were 58 and 39%. Among the several factors examined, positive lymph node (P = 0.016), metastasis at surgery (P = 0.034), tumor necrosis (P = 0.023) and sarcomatoid differentiation (P < 0.001) were demonstrated as independent significant risk factors on multivariable analysis.ConclusionThe OS was poor for patients with RCC with VTT. Rather than VTT level, positive lymph node, metastasis at surgery, tumor necrosis and sarcomatoid differentiation were independent prognostic predictors.

【 授权许可】

CC BY