Effect of Inferior Vena Cava Tumor Thrombus on Overall Survival in Metastatic Renal Cell Carcinoma Patients Treated with Cytoreductive Nephrectomy

In metastatic renal cell carcinoma (mRCC) patients treated with cytoreductive nephrectomy (CN), tumor thrombus involvement within the vascular system is found frequently (40%). Presence of supradiaphragmatic inferior vena cava (IVC) tumor thrombus/IVC invasion (pT3c) in mRCC patients treated with CN...

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Published in:European urology open science (Online) 2022-10, Vol.44, p.94-101
Main Authors: Hoeh, Benedikt, Flammia, Rocco Simone, Hohenhorst, Lukas, Sorce, Gabriele, Panunzio, Andrea, Tappero, Stefano, Tian, Zhe, Saad, Fred, Gallucci, Michele, Briganti, Alberto, Terrone, Carlo, Shariat, Shahrokh F., Graefen, Markus, Tilki, Derya, Antonelli, Alessandro, Kosiba, Marina, Mandel, Philipp, Kluth, Luis A., Becker, Andreas, Chun, Felix K.H., Karakiewicz, Pierre I.
Format: Article
Language:English
Subjects:
Cytoreductive nephrectomy
Inferior vena cava thrombus
Kidney Cancer
Metastatic renal cell carcinoma
Renal vein thrombus
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Summary:In metastatic renal cell carcinoma (mRCC) patients treated with cytoreductive nephrectomy (CN), tumor thrombus involvement within the vascular system is found frequently (40%). Presence of supradiaphragmatic inferior vena cava (IVC) tumor thrombus/IVC invasion (pT3c) in mRCC patients treated with CN is associated with worse overall survival, as compared with pT3a/pT3b patients. Survival data regarding cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) patients according to the type and extent of tumor-associated vascular thrombus are scarce. To test for survival differences in mRCC patients treated with CN according to the type and extent of tumor-associated vascular thrombus. Within Surveillance, Epidemiology, and End Results Research Plus (2004–2017), we identified CN mRCC patients with renal vein (pT3a-TT) versus infradiaphragmatic inferior vena cava (IVC; pT3b) versus supradiaphragmatic IVC tumor thrombus/IVC invasion (pT3c). Overall survival (OS) was addressed in Kaplan-Meier and Cox regression analyses, in addition to 3-mo landmark analyses. Of 2170 mRCC patients, 1880 (87%), 204 (9%), and 86 (4%) harbored pT3a-TT, pT3b, and pT3c, respectively. The respective median OS periods were 21, 23, and 12 mo (p 
ISSN:2666-1683
2666-1691
2666-1683
DOI:10.1016/j.euros.2022.08.011