The influence of venous tumor thrombus combined with bland thrombus on the surgical treatment and prognosis of renal cell carcinoma patients

Autor: Shudong Zhang, Shumin Wang, Li Zhang, Lulin Ma, Zhuo Liu, Qiming Zhang, Guodong Zhu, Yi Huang, Ran Peng, Cheng Liu, Binshuai Wang, Hongxian Zhang, Guoliang Wang, Xiaojun Tian, Xun Zhao, Peng Hong, Feilong Yang, Zhenghui Sun, Zhigang Chen, Shiying Tang, Liwei Li
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Cancer Research
Blood Loss
Surgical
Kaplan-Meier Estimate
Renal Veins
Postoperative Complications
0302 clinical medicine
Renal cell carcinoma
bland thrombus
Surgical treatment
Original Research
Venous Thrombosis
medicine.diagnostic_test
Hazard ratio
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Magnetic Resonance Imaging
Kidney Neoplasms
Oncology
030220 oncology & carcinogenesis
Female
Renal vein
Erythrocyte Transfusion
medicine.medical_specialty
renal cell carcinoma
surgical treatment
Operative Time
Urology
Vena Cava
Inferior
lcsh:RC254-282
Statistics
Nonparametric
03 medical and health sciences
Tumor thrombus
medicine
Humans
Radiology
Nuclear Medicine and imaging
Thrombus
Carcinoma
Renal Cell
Proportional Hazards Models
Retrospective Studies
Chi-Square Distribution
business.industry
Clinical Cancer Research
Thrombosis
Magnetic resonance imaging
medicine.disease
030104 developmental biology
Mann–Whitney U test
prognosis
business
Zdroj: Cancer Medicine, Vol 9, Iss 16, Pp 5860-5868 (2020)
Cancer Medicine
ISSN: 2045-7634
Popis: Objective To describe the clinical characteristics of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and bland thrombus (BT), and to evaluate the influence of BT on surgical treatment and cancer‐specific survival (CSS) of RCC with VTT. Methods We retrospectively reviewed clinical data of 123 patients with RCC and VTT, who underwent surgical treatment in our center between February 2015 and May 2018. Patients were divided into the BT group (21 patients) and non‐BT group (102 patients). Chi‐square and Mann‐Whitney U test were used for categorical and continuous variables respectively. Univariable log‐rank tests and multivariable Cox regressions were conducted to evaluate the prognostic significance of each variable. Kaplan‐Meier plots were performed to evaluate the influence of BT. Results In the delayed phase of enhanced magnetic resonance imaging (MRI), BT and VTT had difference. Patients were divided according to the relative position of BT: proximal end BT (one patients), contralateral renal vein BT (two patients), distal end BT (12 patients), and multiple BT (six patients). The average length of BT was 8.4 ± 5.8 cm (range: 0.6‐20.0 cm). Patients with BT had longer operative time (P = .001), more surgical blood loss (P = .004), higher proportion of open surgery (P = .006), more postoperative complications (P = .011). BT (hazard ratio [HR] = 3.323, P = .007) were independent risk factors for poor prognosis. Conclusions In the delayed phase of enhanced MRI, BT showed no obvious enhancement, while VTT usually showed enhancement. This was an important basis for preoperative imaging diagnosis of BT. The presence of BT increases the difficulty of surgery, and is correlated with adverse survival outcomes in patients with RCC and VTT.
MRI is an important examination for RCC patients with VTT and BT. BT has adverse influence on surgical treatment and survival.
Databáze: OpenAIRE
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