MP57-08 PROGNOSTIC BENEFIT OF SURGICAL MANAGEMENT IN RENAL CELL CARCINOMA PATIENTS WITH THROMBUS EXTENDING TO THE RENAL VEIN AND INFERIOR VENA CAVA: A PROPENSITY SCORE MATCHED ANALYSIS

Abstract

You have accessJournal of UrologyKidney Cancer: Advanced1 Apr 2014MP57-08 PROGNOSTIC BENEFIT OF SURGICAL MANAGEMENT IN RENAL CELL CARCINOMA PATIENTS WITH THROMBUS EXTENDING TO THE RENAL VEIN AND INFERIOR VENA CAVA: A PROPENSITY SCORE MATCHED ANALYSIS Shingo Hatakeyama, Hayato Yamamoto, Akiko Okamoto, Atsushi Imai, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, and Chikara Ohyama Shingo HatakeyamaShingo Hatakeyama More articles by this author , Hayato YamamotoHayato Yamamoto More articles by this author , Akiko OkamotoAkiko Okamoto More articles by this author , Atsushi ImaiAtsushi Imai More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto 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.2014.02.1783AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Management of renal cell carcinoma (RCC) with tumor thrombus extending to the renal vein and inferior vena cava (IVC) is challenging. The aim of this study was to evaluate the benefit of surgical management in such patients. Methods From February 1995 to February 2013, 520 patients were treated for RCC at Hirosaki University Hospital, Hirosaki, Japan. The RCC patients with tumor thrombus extending to the renal vein (n = 42) and IVC (n = 43) were included in this study. The records of these 85 patients were retrospectively reviewed to assess the relevant clinical and pathological variables and survival. Prognostic factors were identified by multivariate analysis. The benefit of surgical management was evaluated using propensity score matching to compare overall survival between patients who received surgical management and those who did not. Results RCC was confirmed by pathological examination of surgical or biopsy specimens in 74 of the 85 patients (87%). Sixty-five patients (76%) received surgical management (radical nephrectomy with thrombectomy). Distant metastasis was identified in 45 patients (53%). The proportion of patients with tumor thrombus level 0 (renal vein only), I, II, III, and IV was 49%, 13%, 18%, 14%, and 5%, respectively. The estimated 5-year overall survival rate was 70% in patients with thrombus extending to the renal vein and 23% in patients with thrombus extending to the IVC. Multivariate analysis identified thrombus extending to the IVC, presence of distant metastasis, surgical management, serum albumin concentration, serum choline esterase concentration, neutrophil-lymphocyte ratio, and Carlson comorbidity index as independent prognostic factors. In propensity score-matched patients, overall survival was significantly longer in those who received surgical management than those who did not. Conclusions Surgical management may improve the prognosis of RCC patients with thrombus extending to the renal vein and IVC. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e644 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Shingo Hatakeyama More articles by this author Hayato Yamamoto More articles by this author Akiko Okamoto More articles by this author Atsushi Imai More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto 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 ...