You have accessJournal of UrologyKidney Cancer: Advanced (II)1 Apr 20131910 IMPACT OF HISTOLOGIC SUBTYPE ON ONCOLOGIC OUTCOME IN PATIENTS WITH RENAL CELL CARCINOMA WITH VENOUS TUMOR THROMBUS Yong Hyun Park, Kyung Don Baik, Young Ju Lee, Ja Hyeon Ku, Cheol Kwak, and Hyeon Hoe Kim Yong Hyun ParkYong Hyun Park Seoul, Korea, Republic of More articles by this author , Kyung Don BaikKyung Don Baik Seoul, Korea, Republic of More articles by this author , Young Ju LeeYoung Ju Lee Seoul, Korea, Republic of More articles by this author , Ja Hyeon KuJa Hyeon Ku Seoul, Korea, Republic of More articles by this author , Cheol KwakCheol Kwak Seoul, Korea, Republic of More articles by this author , and Hyeon Hoe KimHyeon Hoe Kim Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2329AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal cell carcinoma (RCC) with venous tumor thrombus can be cured surgically, however, recurrence developed in a significant proportion of patients. We aimed to analyze the prognostic impact of histologic subtype on oncologic outcomes in patients with RCC with venous tumor thrombus. METHODS We retrospectively reviewed 166 consecutive patient with RCC with venous tumor thrombus who underwent curative surgery. The level of the tumor thrombus was classified as limited to the renal vein (n=125, 75.3%), extending into the IVC below the diaphragm (n=34, 20.5%) and extending above the diaphragm to the atrium (n=7, 4.2%). The prognostic role of histologic subtype on cancer-specific and progression-free survival was evaluated with adjustment for known confounding risk factors by means of Cox regression models. RESULTS The median follow-up duration was 37.1 (6-222) months. Histologic subtypes were clear cell in 134 (80.7%) patients, and non-clear cell in 32 (19.3%) patients. Patients with non-clear cell RCC were significantly younger (59.5 vs. 53.0 years, p=0.021). There were no significant differences with respect to gender, body mass index, performance status, pathologic stage, tumor size and nuclear grade between two groups. Patients with non-clear cell RCC showed significantly lower 5-year progression-free survival (34.3 vs. 18.1%, p=0.038), and cancer-specific survival (58.3 vs. 46.0%, p=0.042). On multivariate analysis, after adjusting for the other clinical and pathologic variables, non-clear cell histology was independently associated with higher recurrence (HR 1.864, 95% CI 1.210-2.274, p=0.025), and cancer-related mortality (HR 1.533, 95% CI 1.089-2.016, p=0.039) in patient with venous tumor thrombus. CONCLUSIONS In patients with RCC with venous tumor thrombus, non-clear cell histology is an independent predictor of progression-free and cancer-specific survival. The histologic subtype could help in identifying patients at high risk for progression or death who may benefit from adjuvant treatment with targeted agents. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e783 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yong Hyun Park Seoul, Korea, Republic of More articles by this author Kyung Don Baik Seoul, Korea, Republic of More articles by this author Young Ju Lee Seoul, Korea, Republic of More articles by this author Ja Hyeon Ku Seoul, Korea, Republic of More articles by this author Cheol Kwak Seoul, Korea, Republic of More articles by this author Hyeon Hoe Kim Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...