Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival.

Autor: Mager R; Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany. rene.mager@unimedizin-mainz.de., Daneshmand S; USC/Norris Comprehensive Cancer Center, Los Angeles, California., Evans CP; Department of Urology, UC Davis Medical Center, Sacramento, California., Palou J; Department of Urology, Fundació Puigvert, Barcelona, Spain., Martínez-Salamanca JI; Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain., Master VA; Department of Urology, Emory University, Atlanta, Georgia., McKiernan JM; Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York., Libertino JA; Department of Urology, Lahey Clinic, Burlington, Massachusetts., Haferkamp A; Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany., Haferkamp A; Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany., Capitanio U; Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy., Carballido JA; Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain., Chantada V; Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain., Chromecki T; Department of Urology, Medical University of Graz, Graz, Austria., Ciancio G; Miami Transplant Institute, University of Miami, Miami, Florida., Daneshmand S; USC/Norris Comprehensive Cancer Center, Los Angeles, California., Evans CP; Department of Urology, UC Davis Medical Center, Sacramento, California., Gontero P; Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy., González J; Department of Urology, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain., Hohenfellner M; Department of Urology, University of Heidelberg, Heidelberg, Germany., Huang WC; Department of Urology, New York University School of Medicine, New York, New York., Koppie TM; Department of Urology, Oregon Health and Science University, Portland, Oregon., Libertino JA; Department of Urology, Lahey Clinic, Burlington, Massachusetts., Espinós EL; Department of Urology, Hospital Universitario Infanta Sofía, Madrid, Spain., Lorentz A; Department of Urology, Emory University, Atlanta, Georgia., Martínez-Salamanca JI; Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain., Master VA; Department of Urology, Emory University, Atlanta, Georgia., McKiernan JM; Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York., Montorsi F; Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy., Novara G; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy., O'Malley P; Department of Urology, Weill Cornell Medical Center, New York, New York., Pahernik S; Department of Urology, University of Heidelberg, Heidelberg, Germany., Palou J; Department of Urology, Fundació Puigvert, Barcelona, Spain., Moreno JL; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Pruthi RS; Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina., Faba OR; Department of Urology, Fundació Puigvert, Barcelona, Spain., Russo P; Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York., Scherr DS; Department of Urology, Weill Cornell Medical Center, New York, New York., Shariat SF; Department of Urology, Medical University of Vienna, Vienna, Austria., Spahn M; Department of Urology, University of Würzburg, Würzburg, Germany., Terrone C; Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy., Tilki D; Department of Urology, UC Davis Medical Center, Sacramento, California., Vázquez-Martul D; Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain., Donoso CV; Hospital Universitario y Politécnico La Fe, Valencia, Spain., Vergho D; Department of Urology, University of Würzburg, Würzburg, Germany., Wallen EM; Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina., Zigeuner R; Department of Urology, Medical University of Graz, Graz, Austria.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2016 Nov; Vol. 114 (6), pp. 764-768. Date of Electronic Publication: 2016 Aug 26.
DOI: 10.1002/jso.24395
Abstrakt: 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;114:764-768. © 2016 Wiley Periodicals, Inc.
(© 2016 Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz: