Long-term functional outcomes in patients undergoing radical nephrectomy for renal cell carcinoma and tumor thrombus

Background Up to 15% of patients with locally advanced renal cell carcinoma (RCC) harbors tumor thrombus (TT). In those cases, radical nephrectomy (RN) and thrombectomy represents the standard of care. We assessed the impact of TT on long-term functional and oncological outcomes in a large contempor...

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Bibliographic Details
Published in:World journal of urology 2024-04, Vol.42 (1), p.264-264, Article 264
Main Authors: Scilipoti, Pietro, Rosiello, Giuseppe, Larcher, Alessandro, Fallara, Giuseppe, Cignoli, Daniele, Re, Chiara, Musso, Giacomo, Cei, Francesco, Tian, Zhe, Karakiewicz, Pierre I., Mottrie, Alexandre, Trevisani, Francesco, Raggi, Daniele, Necchi, Andrea, Bertini, Roberto, Salonia, Andrea, Briganti, Alberto, Montorsi, Francesco, Capitanio, Umberto
Format: Article
Language:English
Subjects:
Aged
Blood clots
Carcinoma, Renal Cell - surgery
Epidermal growth factor receptors
Female
Glomerular filtration rate
Humans
Kidney cancer
Kidney diseases
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Metastases
Middle Aged
Neoplastic Cells, Circulating
Nephrectomy
Nephrectomy - methods
Nephrology
Oncology
Original Article
Patients
Postoperative Complications - epidemiology
Prospective Studies
Regression analysis
Renal cell carcinoma
Renal function
Retrospective Studies
Risk factors
Thrombectomy - methods
Thrombosis
Time Factors
Treatment Outcome
Tumors
Urology
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Summary:Background Up to 15% of patients with locally advanced renal cell carcinoma (RCC) harbors tumor thrombus (TT). In those cases, radical nephrectomy (RN) and thrombectomy represents the standard of care. We assessed the impact of TT on long-term functional and oncological outcomes in a large contemporary cohort. Methods Within a prospective maintained database, 1207 patients undergoing RN for non-metastatic RCC between 2000 and 2021 at a single tertiary centre were identified. Of these, 172 (14%) harbored TT. Multivariable logistic regression analyses evaluated the impact of TT on the risk of postoperative acute kidney injury (AKI). Multivariable Poisson regression analyses estimated the risk of long-term chronic kidney disease (CKD). Kaplan Meier plots estimated disease-free survival and cancer specific survival. Multivariable Cox regression models assessed the main predictors of clinical progression (CP) and cancer specific mortality (CSM). Results Patients with TT showed lower BMI (24 vs. 26 kg/m 2 ) and preoperative Hb (11 vs. 14 g/mL; all— p  
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-024-04976-5