1801 COMPLICATIONS AND OUTCOMES FOR PATIENTS WITH RENAL CELL CARCINOMA AND VENOUS TUMOR THROMBUS: RESULTS FROM THE MAYO CLINIC

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You have accessJournal of UrologyKidney Cancer: Advanced I1 Apr 20121801 COMPLICATIONS AND OUTCOMES FOR PATIENTS WITH RENAL CELL CARCINOMA AND VENOUS TUMOR THROMBUS: RESULTS FROM THE MAYO CLINIC Simon Kim, Stephen Boorjian, R. Houston Thompson, Christopher Weight, Jeffrey Wang, Christine Lohse, John Cheville, and Bradley Leibovich Simon KimSimon Kim Rochester, MN More articles by this author , Stephen BoorjianStephen Boorjian Rochester, MN More articles by this author , R. Houston ThompsonR. Houston Thompson Rochester, MN More articles by this author , Christopher WeightChristopher Weight Rochester, MN More articles by this author , Jeffrey WangJeffrey Wang Rochester, MN More articles by this author , Christine LohseChristine Lohse Rochester, MN More articles by this author , John ChevilleJohn Cheville Rochester, MN More articles by this author , and Bradley LeibovichBradley Leibovich Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1832AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately 10% of patients diagnosed with renal cell carcinoma (RCC) present with venous tumor thrombus. However, the clinical outcomes of patients undergoing nephrectomy and tumor thrombectomy for RCC continue to be defined. In this context, we sought to assess complications, in-hospital outcomes, and survival by level of venous tumor thrombus from a large historical cohort. METHODS We identified 640 patients who underwent radical nephrectomy for RCC with venous tumor thrombus between 1980 and 2009. Primary outcomes assessed were intraoperative estimated blood loss (EBL), hospital length of stay (LOS), early (within 30 days) and late (30 days-1 year) complications, and cancer-specific survival (CSS). Comparisons of complications, EBL, and LOS by level of tumor thrombus were evaluated using chi-square and Kruskal-Wallis tests. CSS was estimated using the Kaplan Meier method and compared by level of tumor thrombus using the log rank test. RESULTS Median follow-up after surgery was 5.9 years (range 0-30). CSS rates at 5 and 10 years were 45% and 34%, respectively. A total of 357 (56%) patients presented with level 0 tumor thrombus, 78 (12%) with level I, 113 (18%) with level II, 47 (7%) with level III, and 45 (7%) with level IV. Overall, 94 (15%) patients experienced early complications and 230 (36%) experienced late complications. Patients with higher levels of venous tumor thrombus were more likely to experience early complications and to have a higher EBL and LOS (Table). No difference in late complications was noted according to the height of the thrombus. CSS only differed by level of tumor thrombus when comparing level 0 tumor thrombus to levels I-IV (57% vs. 43%; p<0.001). CONCLUSIONS Increasing level of venous tumor thrombus was associated with greater adverse in-hospital outcomes and worse CSS among patients undergoing surgery for RCC. These data emphasize the technical challenges that may be associated with these procedures, and highlight the need for continued efforts to maximize the safety and oncologic efficacy of treatment. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e726-e727 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Simon Kim Rochester, MN More articles by this author Stephen Boorjian Rochester, MN More articles by this author R. Houston Thompson Rochester, MN More articles by this author Christopher Weight Rochester, MN More articles by this author Jeffrey Wang Rochester, MN More articles by this author Christine Lohse Rochester, MN More articles by this author John Cheville Rochester, MN More articles by this author Bradley Leibovich Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...