Prognostic Outcomes and Risk Factors for Patients with Renal Cell Carcinoma and Venous Tumor Thrombus after Radical Nephrectomy and Thrombectomy: The Prognostic Significance of Venous Tumor Thrombus Level.

Qi Tang,Qian Zhang,Maxwell Meng,Zhisong He,Liqun Zhou,Xuesong Li,Yi Song,Jin Wang

doi:10.1155/2015/163423

Abstract

Introduction. To evaluate the prognostic outcomes and risk factors for renal cell carcinoma (RCC) patients with venous tumor thrombus in China. Materials and Methods. We reviewed the clinical information of 169 patients who underwent radical nephrectomy and thrombectomy. Overall and cancer-specific survival rates were analyzed. Univariate and multivariate analyses were used to investigate the potential prognostic factors. Results. The median survival time was 63 months. The five-year overall survival and cancer-specific survival rate were 53.6% and 54.4% for all patients. For all patients, significant survival difference was only observed between early (below hepatic vein) and advanced (above hepatic vein) tumor thrombus. However, significant differences existed between both RV/IVC and early/advanced tumor thrombus groups in N0M0 patients. Multivariate analysis demonstrated that higher tumor thrombus level (p = 0.016, RR = 1.58), N (p = 0.013, RR = 2.60), and M (p < 0.001, RR = 4.14) stages and adrenal gland invasion (p = 0.001, RR = 4.91) were the most significant negative prognostic predictors. Conclusions. In this study, we reported most cases of RCC patients with venous extension in China. We proved that patients with RCC and venous tumor thrombus may have relative promising long-term survival rate, especially those with early tumor thrombus.

Highlights

To evaluate the prognostic outcomes and risk factors for renal cell carcinoma (RCC) patients with venous tumor thrombus in China
The objectives of the present study were to report our experience in the surgical management of RCC patients with venous tumor thrombus, to assess the overall survival and cancer-specific survival rate of Chinese patients and to evaluate the significance of potential prognostic factors, especially the venous tumor thrombus level
Level II inferior vena cava (IVC) thrombus represents those that extend above the hepatic veins but below the diaphragm, and level III IVC thrombus is defined as a tumor thrombus that extends above the diaphragm or into the right atrium

Summary

Introduction

To evaluate the prognostic outcomes and risk factors for renal cell carcinoma (RCC) patients with venous tumor thrombus in China. Significant survival difference was only observed between early (below hepatic vein) and advanced (above hepatic vein) tumor thrombus. Significant differences existed between both RV/IVC and early/advanced tumor thrombus groups in N0M0 patients. We reported most cases of RCC patients with venous extension in China. We proved that patients with RCC and venous tumor thrombus may have relative promising long-term survival rate, especially those with early tumor thrombus. Tumor extension to the venous system, including the renal vein (RV) and the inferior vena cava (IVC), is a feature of locally advanced RCC and occurs in approximately 4–10% of cases [3]. There are data reporting the long-term outcomes of these patients worldwide, reliable statistics based on a large number of patients in China remain lacking

Objectives

Methods

Results

Conclusion