Vein Invasion in Renal Cell Carcinoma: Impact on Metastatic Behavior and Survival

Ljungberg, Börje; Stenling, Roger; Osterdahl, Bjorn; Farrelly, Elisabeth; Åberg, Torkel; Roos, Göran

doi:10.1016/s0022-5347(01)66749-1

Cited by 110 publications

(69 citation statements)

References 17 publications

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“…This result could have been due to the relatively small size of the group with IVC extension. Furthermore, the presence of invasion of IVC wall, not the level of tumor thrombus, was found to be a significant prognostic factor of survival in several studies (26)(27)(28). Thus, invasion of IVC wall by tumor thrombus rather than thrombus level may predict a poor prognosis.…”

Section: Discussionmentioning

confidence: 96%

Prognostic factor for Korean patients with renal cell carcinoma and venous tumor thrombus extension: application of the new 2009 TNM staging system

et al. 2013

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Purpose: To study the surgical outcomes of radical nephrectomy with thrombectomy and to determine prognostic factors for survival of Korean patients with renal cell carcinoma (RCC) and venous tumor thrombus. Materials and Methods: A total of 124 patients with RCC and venous tumor thrombus who underwent radical nephrectomy and thrombectomy were included in this retrospective study. Cancer-specific survival (CSS) and recurrence-free survival (RFS) rates were analyzed retrospectively according to various prognostic factors. Results: The median overall follow-up period for all patients was 29.0 months; the median survival period was 50.0 months. The 2-, 5-and 10-year CSS rates for all patients were 64.2%, 47.1% and 31.7%, respectively. Those for 76 patients (pN0/xM0) without metastasis at presentation were 80.9%, 64.5% and 44.9%, respectively. For all patients, lower body mass index (BMI), higher Fuhrman grade, presence of symptoms, perinephric fat invasion, invasion of inferior vena cava (IVC) wall, lymph node (LN) involvement and distant metastasis at presentation were independent predictors for decreased CSS on multivariate analysis, while thrombus level was not. For non-metastatic patients, lower BMI, presence of symptoms and tumor size were independently associated with decreased CSS. In terms of RFS, lower BMI, presence of perinephric fat invasion were prognostic factors for recurrence. Conclusions: Our data suggest that obesity is independently associated with better survival or lower risk of tumor recurrence in Korean patients undergoing radical nephrectomy with tumor thrombectomy. Also, our results indicate that Fuhrman grade, presence of symptoms, perinephric fat invasion and invasion of IVC wall, LN involvement and distant metastasis at presentation are independent predictors for survival.

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Section: Discussionmentioning

confidence: 96%

Prognostic factor for Korean patients with renal cell carcinoma and venous tumor thrombus extension: application of the new 2009 TNM staging system

et al. 2013

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“…By contrast, other studies proposed that the presence of a tumor thrombus did not reduce the survival rate and increase the risk of further metastasis (5,16,17). IVC invasion and a friable thrombus were reported as independent prognostic factors in two studies (18,19). In general, non-metastatic renal tumors with venous thrombi have a better prognosis following nephrectomy and tumor thrombectomy compared with patients with metastatic disease.…”

Section: Discussionmentioning

confidence: 90%

Surgical resection of recurrent inferior vena cava tumor following radical nephrectomy for renal cell carcinoma: A case report

Zhang

Xie

et al. 2015

Oncology Letters

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Abstract. Late recurrence is a known characteristic of the biological behavior of renal cell carcinoma (RCC) following radical nephrectomy. However, the development of recurrent inferior vena cava (IVC) tumors following radical nephrectomy for RCC is a rare event, and surgical resection of recurrent IVC tumors is a challenge for urologists. The present study reports the case of a patient with a local recurrent tumor in the IVC following a right radical nephrectomy 4 years previously for RCC. The patient was referred to the Department of Urology, First Affiliated Hospital of Anhui Medical University, due to bilateral lower extremity edema, and magnetic resonance imaging showed an intraluminal tumor thrombus in the IVC. Therefore, a thrombectomy and partial IVC resection with defect reconstruction were performed successfully. The results of follow-up for 72 months showed that there were no signs of recurrence as local or distant metastasis. This case of local recurrence in the IVC highlights that active long-term surveillance for RCC patients of all stages is important for the early diagnosis of tumor recurrence, which improves the potential resectability.

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“…Urinary cytological analysis was reported to have a diagnostic accuracy of 59%, but with a high ratio of false negatives for malignancy (5). A CT scan finding of preserved reniform kidney shape by an infiltrating neoplastic process supports the diagnosis of UC (2).…”

Section: Discussionmentioning

confidence: 99%

Massive renal urothelial carcinoma with renal vein tumor thrombus, pancreatic infiltration and adrenal metastasis: A case report

Gao

et al. 2016

Oncology Letters

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Abstract.A 49-year-old female patient presented with a massive left renal tumor, recurrent left flank pain and gross hematuria. The tumor was accompanied by a renal vein tumor thrombus, pancreatic infiltration and a solitary adrenal metastasis. Radical nephrectomy, distal pancreatectomy, ipsilateral adrenalectomy and splenectomy were performed. Histopathological examination suggested high-grade urothelial carcinoma (UC); however, tumor recurrence and multiple metastases were detected only 3 months after the surgery, and the patient succumbed during follow-up 1 month later. To the best of our knowledge, this is the first case of renal UC of such advanced stage with renal vein tumor thrombus, pancreatic infiltration and a solitary adrenal metastasis.

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Vein Invasion in Renal Cell Carcinoma: Impact on Metastatic Behavior and Survival

Abstract: Our study indicates that vein invasion itself seems to be an important prognostic factor in renal cell carcinoma.

Cited by 110 publications

References 17 publications

Prognostic factor for Korean patients with renal cell carcinoma and venous tumor thrombus extension: application of the new 2009 TNM staging system

Prognostic factor for Korean patients with renal cell carcinoma and venous tumor thrombus extension: application of the new 2009 TNM staging system

Surgical resection of recurrent inferior vena cava tumor following radical nephrectomy for renal cell carcinoma: A case report

Massive renal urothelial carcinoma with renal vein tumor thrombus, pancreatic infiltration and adrenal metastasis: A case report

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