MP16-13 CLINICAL BENEFIT OF PRESURGICAL AXITINIB THERAPY IN RENAL CELL CARCINOMA PATIENTS WITH THROMBUS EXTENDING TO INFERIOR VENA CAVA

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced (including Drug Therapy) II1 Apr 2017MP16-13 CLINICAL BENEFIT OF PRESURGICAL AXITINIB THERAPY IN RENAL CELL CARCINOMA PATIENTS WITH THROMBUS EXTENDING TO INFERIOR VENA CAVA Yoshimi Tanaka, Yasuhiro Hashimoto, Shingo Hatakeyama, Shogo Hosogoe, Toshikazu Tanaka, Masaaki Oikawa, Kazuhisa Hagiwara, Takuma Narita, Daisuke Noro, Yuki Tobisawa, Hayato Yamamoto, Tohru Yoneyama, Takahiro Yoneyama, Takuya Koie, and Chikara Ohyama Yoshimi TanakaYoshimi Tanaka More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Shogo HosogoeShogo Hosogoe More articles by this author , Toshikazu TanakaToshikazu Tanaka More articles by this author , Masaaki OikawaMasaaki Oikawa More articles by this author , Kazuhisa HagiwaraKazuhisa Hagiwara More articles by this author , Takuma NaritaTakuma Narita More articles by this author , Daisuke NoroDaisuke Noro More articles by this author , Yuki TobisawaYuki Tobisawa More articles by this author , Hayato YamamotoHayato Yamamoto More articles by this author , Tohru YoneyamaTohru Yoneyama More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Takuya KoieTakuya Koie More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.519AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We aimed to investigate clinical and pathological antitumor effects of presurgical axitinib for renal cell carcinoma (RCC) extending into inferior vena cava (IVC). METHODS From March 1995 to June 2016, we treated consecutive 38 RCC patients with IVC thrombus in our hospital. Patients were divided into those receiving radical nephrectomy alone (control) and those receiving presurgical axitinib before planned radical nephrectomy (Neo-Axi). Patients’ background, clinicopathological parameters, and prognosis were compared between the control and Neo-Axi groups. In the Neo-Axi group, tumor responses were evaluated by RECIST v1.1 before and after axitinib including renal tumor and IVC thrombus. Fibrosis within IVC thrombus was evaluated by Azan staining, and interstitial fibrosis (IF) rates were compared between the control and Neo-Axi groups. RESULTS The number of patients in the control and Neo-Axi groups were 30 and 8, respectively. There were no significantly differences in age, sex, thrombus level, metastatic disease, MSKCC risk classification between the control and Neo-Axi group. Axitinib-related adverse events were grade 3 hypertensions (n=3) and diarrhea (n=1). Median tumor responses in renal tumor and IVC thrombus were 22.3% and 41.1%, respectively. Median regression IVC thrombus was 15.5 mm. Median operation time and blood loss between the control and Neo-Axi group were significantly different (318 vs. 204 minutes, 2450 vs. 450 grams, respectively). One patient experienced perioperative death due to lung thrombosis in the control group. Pathological complete response (pT0) was obtained in one patient (12.5%) in the Neo-Axi group. Median interstitial fibrosis rate of IVC thrombus was significantly higher in the Neo-Axi group compared with the control group (8.7% and 3.4%, respectively, P=0.0021). Progression free survival between the control and Neo-Axi group were 13 and 33 months, respectively (P=0.060). Overall survival between the control and Neo-Axi group were 41 months and undefined, respectively (P=0.071). CONCLUSIONS Presurgical axitinib therapy enhanced tumor reduction accompanied by fibrosis, and may contribute surgical risk reduction. Presurgical axitinib therapy might be feasible option for RCC with IVC thrombus. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e184 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Yoshimi Tanaka More articles by this author Yasuhiro Hashimoto More articles by this author Shingo Hatakeyama More articles by this author Shogo Hosogoe More articles by this author Toshikazu Tanaka More articles by this author Masaaki Oikawa More articles by this author Kazuhisa Hagiwara More articles by this author Takuma Narita More articles by this author Daisuke Noro More articles by this author Yuki Tobisawa More articles by this author Hayato Yamamoto More articles by this author Tohru Yoneyama More articles by this author Takahiro Yoneyama More articles by this author Takuya Koie More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...