Effect of Inferior Vena Cava Tumor Thrombus on Overall Survival in Metastatic Renal Cell Carcinoma Patients Treated with Cytoreductive Nephrectomy

Hoeh, Benedikt; Flammia, Rocco Simone; Hohenhorst, Lukas; Sorce, Gabriele; Panunzio, Andrea; Tappero, Stefano; Tian, Zhe; Saad, Fred; Gallucci, Michele; Briganti, Alberto; Terrone, Carlo; Shariat, Shahrokh F.; Graefen, Markus; Tilki, Derya; Antonelli, Alessandro; Kosiba, Marina; Mandel, Philipp; Kluth, Luis A.; Becker, Andreas; Chun, Felix K.‐H.; Karakiewicz, Pierre I.

doi:10.1016/j.euros.2022.08.011

Cited by 2 publications

(2 citation statements)

References 35 publications

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“…Cancer-specific survival is 5 years following complete resection of TT in all grades of RCC without metastatic disease [10]. In RCC patients with metastatic disease and TT, patients treated with cytoreductive nephrectomy and thrombectomy had a median overall survival of 1 year [11]. Multiple case reports now document that immunotherapy has decreased the size of TT.…”

Section: Introductionmentioning

confidence: 99%

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Williams,

Myint

2023

Cancers

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Tumor thrombus (TT) is a complication of renal cell carcinoma (RCC) for which favorable medical management remains undefined. While radical nephrectomy has been shown to increase overall survival in RCC patients, surgical interventions such as cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) utilized to perform TT resection carry high mortality rates. While it has been documented that RCC with TT is associated with venous thromboembolism (VTE) development, anticoagulation use in these patients remains controversial in clinical practice. Whether anticoagulation is associated with improved survival outcomes remains unclear. Furthermore, if anticoagulation is initiated, there is limited evidence for whether direct oral anticoagulants (DOACs), heparin, or warfarin serve as the most advantageous choice. While the combination of immunotherapy and tyrosine kinase inhibitors (TKIs) has been shown to improve the outcomes of RCC, the clinical benefits of this combination are not well studied prospectively in cases with TT. In this literature review, we explore the challenges of treating RCC-associated TT with special attention to anticoagulation. We provide a comprehensive overview of current surgical and medical approaches and summarize recent studies investigating anticoagulation in RCC patients undergoing surgery, targeted therapy, and/or immunotherapy. Our goal is to provide clinicians with updated clinical insight into anticoagulation for RCC-associated TT patients.

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Section: Introductionmentioning

confidence: 99%

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Williams,

Myint

2023

Cancers

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“…Other researchers found such a correlation, though ( 22 ), and the differences in these findings may have explanations in e.g., the selection bias. An interesting analysis of the SEER database was published recently indicating poorer results in pT3c metastatic RCC patients than in their pT3a-b cohort ( 23 ). On the other hand, the authors emphasized that the expected OS of pT3c patients was still 12 months or more with cytoreductive nephrectomy when compared with virtually 24-month OS in the latter group.…”

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confidence: 99%

Improving the prognostic accuracy in renal cell carcinoma with venous thrombus with novel predictive nomograms

Zapała¹,

Kunc²,

Radziszewski³

2022

Transl Androl Urol

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Effect of Inferior Vena Cava Tumor Thrombus on Overall Survival in Metastatic Renal Cell Carcinoma Patients Treated with Cytoreductive Nephrectomy

Cited by 2 publications

References 35 publications

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

The Role of Anticoagulation in Tumor Thrombus Associated with Renal Cell Carcinoma: A Literature Review

Improving the prognostic accuracy in renal cell carcinoma with venous thrombus with novel predictive nomograms

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