MP44-11 PROGNOSTIC SIGNIFICANCE OF DEGREE OF RENAL VEIN INVOLVEMENT IN PATIENTS WITH PATHOLOGIC T3A RENAL CELL CARCINOMA

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging II1 Apr 2015MP44-11 PROGNOSTIC SIGNIFICANCE OF DEGREE OF RENAL VEIN INVOLVEMENT IN PATIENTS WITH PATHOLOGIC T3A RENAL CELL CARCINOMA Myungsun Shim, Myungchan Park, Aram Kim, Mooyoung Sohn, Jaeyoon Jung, In Gab Jeong, Cheryn Song, Choung-Soo Kim, and Hanjong Ahn Myungsun ShimMyungsun Shim More articles by this author , Myungchan ParkMyungchan Park More articles by this author , Aram KimAram Kim More articles by this author , Mooyoung SohnMooyoung Sohn More articles by this author , Jaeyoon JungJaeyoon Jung More articles by this author , In Gab JeongIn Gab Jeong More articles by this author , Cheryn SongCheryn Song More articles by this author , Choung-Soo KimChoung-Soo Kim More articles by this author , and Hanjong AhnHanjong Ahn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1553AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We aimed to evaluate prognostic significance of degree of renal vein (RV) involvement in patients with T3a RCC. METHODS We retrospectively reviewed the data of 322 T3a RCC patients who underwent nephrectomy between 1997 and 2012 with a follow-up period of at least 1 year. Tumors with perinephric fat, sinus (fat) invasion and RV involvement were identified as T3a tumors, and degree of RV involvement were classified as RV thrombi only (TI) and RV wall invasion (WI). Recurrence-free survival (RFS) and cancer-specific survival (CSS) rates were assessed by Kaplan-Meier curves. Predictors of RFS and CSS were analyzed by Cox regression models. RESULTS One hundred eighteen (36.6%) patients with RV involvement showed significantly worse outcomes compared with 204 (63.4%) patients without RV involvement in terms of 5-year RFS (30.0% vs 54.9%, p < 0.001) and CSS (51.4% vs 75.4%, p < 0.001). Within the patients with RV involvements, 5-year RFS of patients with TI and WI was 49.8% and 16.4% (p < 0.001) whereas CSS was 68.5% and 47.4% (p = 0.001) respectively. Especially, tumors invading venous wall with margin involvement showed worst prognosis (RFS, 0.0%; CSS, 28.6%). Pathologic tumor size, Fuhrman grade (3, 4 vs 1, 2), sarcomatoid differentiation and WI was an independent predictor of recurrence (p < 0.001, 0.012, 0.026 and 0.006, respectively) and cancer death (p = 0.008, 0.026, 0.018, and 0.017, respectively) while TI was not (p = 0.575, 0.803, respectively). Tumors with TI showed comparable prognosis to those of perinephric or sinus invasion. CONCLUSIONS Tumors with RV involvement demonstrated different outcomes according to degree of involvement. The prognosis of tumors that invades venous wall in T3a RCC should be considered as those of tumors that involves vena cava. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e530 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Myungsun Shim More articles by this author Myungchan Park More articles by this author Aram Kim More articles by this author Mooyoung Sohn More articles by this author Jaeyoon Jung More articles by this author In Gab Jeong More articles by this author Cheryn Song More articles by this author Choung-Soo Kim More articles by this author Hanjong Ahn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...