Caval tumor thrombus volume influences outcomes in renal cell carcinoma with venous extension

Zargar‐Shoshtari, Kamran; Espiritu, Patrick; Kurian, Tony; Pow‐Sang, Julio M.; Mangar, Devanand; Sexton, Wade J.; Spiess, Philippe E.

doi:10.1016/j.urolonc.2014.11.015

Cited by 14 publications

(14 citation statements)

References 23 publications

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“…This is a retrospective study from single institutional series with limited follow-up data, but the data set was prospectively maintained, which could partly adjust. Due to the rarity of this specific disease and shorter investigated period, our patient sample was not a large number, but comparable with previous studies [6][7][8]. We may underestimate postoperative complications, given the fact that patients discharged from hospital may not always come back for treatment of complications.…”

Section: Discussionmentioning

confidence: 60%

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A Contemporary High-Volume Center Analysis of Postoperative Complications Following Surgical Management of Renal Cell Carcinoma with Tumor Thrombus

Zhang

Liu

et al. 2019

Urol Int

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Purpose: To define preoperative predictors and construct a preoperative multivariable model for prediction of postoperative complications in patients with renal cell carcinoma (RCC) after nephrectomy with thrombectomy. Materials and Methods: We identified patients with RCC and level I–IV venous tumor thrombus (VTT) who underwent concomitant radical nephrectomy and thrombectomy between February 2015 and March 2018. Univariate and multivariate logistic regression analyses were used to assess the effect of preoperative factors on the incidence of overall and major postoperative complications within 30 days postoperatively. A nomogram for prediction of postoperative complications was also developed using regression coefficients from the multivariable analyses. Results: A total of 120 patients met inclusion criteria. We reported an overall complication rate of 39.2% and major complication rate of 12.5% within 30 days after surgery, with perioperative mortality rate of 2.5%. On multivariate analysis, independent predictors of overall complications included systemic symptoms, comorbidity, level III/IV VTT and serum creatine (SCr) level, while only SCr level was significantly associated with major complications. The internal validation result showed that the accuracy of our preoperative nomogram for overall complications measured by c-index was 0.794. Conclusions: We constructed an accurate preoperative model to predict overall postoperative complications in patients with level I–IV thrombus. External verification is still needed to evaluate its general application.

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Section: Discussionmentioning

confidence: 60%

“…To date, most large series of patients with RCC and VTT focused on long-term prognosis rather than perioperative outcomes, predictors about postoperative complications was seldom reported [5][6][7][8]. There were also several drawbacks with previous studies.…”

Section: Introductionmentioning

confidence: 99%

A Contemporary High-Volume Center Analysis of Postoperative Complications Following Surgical Management of Renal Cell Carcinoma with Tumor Thrombus

Zhang

Liu

et al. 2019

Urol Int

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“…Though our patient was unable to undergo surgery, our institution’s vascular surgery service was involved in the patient’s case early in the planning stages. Interestingly, recent studies have shown that thrombus volume may have more prognostic value than thrombus level 8…”

Section: Discussionmentioning

confidence: 99%

Robust response to nivolumab in patient with renal cell carcinoma inferior vena cava tumour thrombus

Berends¹,

Gourley²,

Kaushik³

2019

BMJ Case Rep

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A 47-year-old previously healthy man presented with acute moderate flank pain. Evaluation revealed left renal cell carcinoma, with inferior vena cava tumour thrombus invasion. Patient had no significant history or risk factors to pre-dispose him to genitourinary cancers. Surgery was deemed to not be appropriate due to distant metastases, but patient received targeted molecular therapy and immunotherapy with striking regression of the thrombus.

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“…Zargar-Shoshtari et al [15] reported in their multivariate analysis a negative effect of nCC histology on the diseasefree survival (P ¼ 0.02, HR ¼ 2.98) and overall survival (P ¼ 0.01, HR ¼ 4.03) of patients after radical nephrectomy with thrombectomy. In another retrospective multicenter analysis of 465 patients with RCC with tumor thrombus, nCCRCC was reported as an independent postsurgery relapse risk factor (HR ¼ 2.13) [16].…”

Section: Nccrcc Surgerymentioning

confidence: 98%

Management of non–clear cell renal cell carcinoma: Current approaches

Tsimafeyeu

2017

Urologic Oncology: Seminars and Original Investigations

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Caval tumor thrombus volume influences outcomes in renal cell carcinoma with venous extension

Cited by 14 publications

References 23 publications

A Contemporary High-Volume Center Analysis of Postoperative Complications Following Surgical Management of Renal Cell Carcinoma with Tumor Thrombus

A Contemporary High-Volume Center Analysis of Postoperative Complications Following Surgical Management of Renal Cell Carcinoma with Tumor Thrombus

Robust response to nivolumab in patient with renal cell carcinoma inferior vena cava tumour thrombus

Management of non–clear cell renal cell carcinoma: Current approaches

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