Impact of Histologic Subtype on Cancer-specific Survival in Patients with Renal Cell Carcinoma and Tumor Thrombus

Tilki, Derya; Nguyen, Hao G.; Dall′Era, Marc; Bertini, Roberto; Carballido, Joaquı́n; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; González, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C.; Koppie, Theresa M.; Lorentz, Adam; Mandel, Philipp; Martínez-Salamanca, Juan Ignacio; Master, Viraj A.; Matloob, Rayan; McKiernan, James M.; Mlynarczyk, Carrie M.; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S.; Ramaswamy, Krishna; Faba, Ó. Rodríguez; Russo, Paul; Shariat, Shahrokh F.; Spahn, Martin; Terrone, Carlo; Vergho, Daniel; Wallen, Eric; Xylinas, Évanguelos; Zigeuner, Richard; Libertino, John A.; Evans, Christopher P.

doi:10.1016/j.eururo.2013.06.048

Cited by 78 publications

(73 citation statements)

References 24 publications

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“…We retrospectively analyzed 362 patients with RCC and with level III or IV tumor thrombus who underwent radical nephrectomy and complete tumor thrombectomy from 1992 to 2012 in 22 US and European centers. The data was centralized via the International Renal Cell Carcinoma-Venous Thrombus Consortium (IRCC-VTC) to ensure data integrity and to address all data inconsistencies prior to the analysis as described previously 6 . Detailed surgical data, demographics, and pathological evaluation were available.…”

Section: Methodsmentioning

confidence: 99%

Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis

et al. 2015

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Purpose The impact of cardiopulmonary bypass (CPB) usage in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We sought to determine the impact of cardiopulmonary bypass (CPB) on overall and cancer specific survival, as well as surgical complication rates, and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without CPB. Patients and Methods We retrospectively analyzed 362 patients with RCC and with level III or IV tumor thrombus from 1992 to 2012 in 22 US and European centers. Cox proportional hazards models were used to compare overall and cancer-specific survival between patients with and without CPB. Perioperative mortality and complications rates were assessed using logistic regression analyses. Results The median overall survival was 24.6 months in non-CPB patients and 26.6 months in CPB patients. Overall survival and cancer-specific survival (CSS) did not differ significantly in both groups, neither in univariate analysis nor when adjusting for known risk factors. In multivariate analysis, no significant differences were seen in hospital LOS, Clavien 1-4 complication rate, intraoperative or 30 day mortality, and CSS between both groups. Limitations include the retrospective nature of the study. Conclusions In our multi-institutional analysis, the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality in the multivariate analysis. Higher surgical complications were not independently associated with the use of CPB.

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Section: Methodsmentioning

confidence: 99%

Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis

et al. 2015

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“…For patients without distant metastases, radical nephrectomy and thrombectomy is the treatment of choice offering the only potential cure [5]. Nevertheless, the risk of tumor recurrence varies substantially considering a 5-year survival rate of 39-64% after surgery [23][24][25]. Several studies have evaluated the prognostic value of clinical, pathological, and molecular markers in RCC to stratify risk groups after radical surgical treatment [13].…”

Section: Discussionmentioning

confidence: 99%

Impact of E-Cadherin and β-Catenin as Prognostic Factor in Renal Cell Carcinoma with Tumor Thrombus of the Vena Cava

et al. 2019

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Purpose: Renal cell carcinoma (RCC) forming tumor thrombus (TT) of vena cava (VC) is characterized by poor prognosis. Nevertheless, the outcome of patients after radical surgery varies. To date only limited data concerning prognostic biomarkers in this RCC subgroup are available. Methods: Out of 159 patients with pT3b/c RCC, 95 patients without synchronous distant metastases at time of diagnosis were included in the study cohort. After immunohistochemical (IHC) evaluation of E-cadherin and β-Catenin expression, association with clinical, histopathological and survival was assessed by univariate analysis, multivariate analysis, and Kaplan-Meier-analysis. Cancer-specific survival (CSS) rates and overall survival (OS) rates were estimated using Kaplan-Meier analysis and compared using Log rank test. Results: We found a significant correlation between E-cadherin overexpression and initial lymph node metastasis (ρ = 0.300, p = 0.003), positive surgical margins (ρ = 0.210, p = 0.043), and the development of distant metastases (ρ = 0.258, p = 0.012). Furthermore, we observed a significant correlation of β-Catenin overexpression with higher tumor stage pT3c (ρ = 0.230, p = 0.028) and initial lymph node metastases (ρ = 0.236, p = 0.025). Survival analysis revealed a statistically significant association of both E-cadherin and β-Catenin overexpression with worse CSS (p < 0.001 and p = 0.007, respectively) and OS (p < 0.001 and p = 0.041, respectively). Multivariate analysis revealed initial lymph node metastasis as the only predictive factor for worse OS (HR 4.54, 95% CI 2.30–8.93; p < 0.001). E-Cadherin and β-Catenin expression failed to be significant in multivariable analysis for OS and CSS. Conclusions: In a large series of RCC with TT of VC high IHC expression of E-cadherin and β-Catenin was associated with initial lymph node metastasis and with both worse OS and worse CSS. This might help to identify patients at risk for recurrence who might benefit from adjuvant therapy or stricter follow-up.

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“…An extensive analysis conducted by Tilki et al [17] confirmed negative nCCRCC effect on surgery outcomes in patients with thrombus. That study included 1,774 patients with RCC and renal thrombus after nephrectomy with thrombectomy at 22 US and European centers.…”

Section: Nccrcc Surgerymentioning

confidence: 94%

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

Tsimafeyeu

2017

Urologic Oncology: Seminars and Original Investigations

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Impact of Histologic Subtype on Cancer-specific Survival in Patients with Renal Cell Carcinoma and Tumor Thrombus

Cited by 78 publications

References 24 publications

Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis

Cardiopulmonary Bypass has No Significant Impact on Survival in Patients Undergoing Nephrectomy and Level III-IV Inferior Vena Cava Thrombectomy: Multi-Institutional Analysis

Impact of E-Cadherin and β-Catenin as Prognostic Factor in Renal Cell Carcinoma with Tumor Thrombus of the Vena Cava

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

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