Journal of surgical oncology. 2016 Aug 26. doi: 10.1002/jso.24395 |
Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival. |
Mager R1, Daneshmand S2, Evans CP3, Palou J4, Martínez-Salamanca JI5, Master VA6, McKiernan JM7, Libertino JA8, Haferkamp A9, Haferkamp A10, Capitanio U11, Carballido JA12, Chantada V13, Chromecki T14, Ciancio G15, Daneshmand S16, Evans CP17, Gontero P18, González J19, Hohenfellner M20, Huang WC21, Koppie TM22, Libertino JA23, Espinós EL24, Lorentz A25, Martínez-Salamanca JI26, Master VA27, McKiernan JM28, Montorsi F29, Novara G30, O'Malley P31, Pahernik S32, Palou J33, Moreno JL34, Pruthi RS35, Faba OR36, Russo P37, Scherr DS38, Shariat SF39, Spahn M40, Terrone C41, Tilki D42, Vázquez-Martul D43, Donoso CV44, Vergho D45, Wallen EM46, Zigeuner R47 |
Abstract BACKGROUND: Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort. METHODS: The records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors. RESULTS: VTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS. CONCLUSIONS: In the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. © 2016 Wiley Periodicals, Inc. |
© 2016 Wiley Periodicals, Inc. |
KEYWORDS: cancer specific survival, renal cell carcinoma, thrombus consistency, venous tumor thrombus |
Publikations ID: 27562252 Quelle: öffnen |