Renal Cell Carcinoma With Inferior Vena Cava Involvement: Prognostic Effect of Tumor Thrombus Consistency on Cancer Specific Survival

被引：31

作者：

Mager, Rene ^{[1
]}

Daneshmand, Siamak ^{[2
]}

Evans, Christopher P. ^{[3
]}

Palou, Joan ^{[4
]}

Martinez-Salamanca, Juan I. ^{[5
,10
]}

Master, Viraj A. ^{[6
]}

Mckiernan, James M. ^{[7
]}

Libertino, John A. ^{[8
]}

Haferkamp, Axel ^{[1
]}

Capitanio, Umberto ^{[9
]}

Carballido, Joaquin A. ^{[10
]}

Chantada, Venancio ^{[11
]}

Chromecki, Thomas ^{[12
]}

Ciancio, Gaetano ^{[13
]}

Daneshmand, Siamak ^{[2
]}

Evans, Christopher P. ^{[3
]}

Gontero, Paolo ^{[14
]}

Gonzalez, Javier ^{[15
]}

Hohenfellner, Markus ^{[16
]}

Huang, William C. ^{[17
]}

Koppie, Theresa M. ^{[18
]}

Libertino, John A. ^{[8
]}

Linares Espinos, Estefania ^{[19
]}

Lorentz, Adam ^{[6
]}

Martinez-Salamanca, Juan I. ^{[5
,10
]}

Master, Viraj A. ^{[6
]}

Mckiernan, James M. ^{[7
]}

Montorsi, Francesco ^{[9
]}

Novara, Giacomo ^{[20
]}

O'Malley, Padraic ^{[21
]}

Pahernik, Sascha ^{[16
]}

Palou, Joan ^{[4
]}

Pontones Moreno, Jose Luis ^{[22
]}

Pruthi, Raj S. ^{[23
]}

Rodriguez Faba, Oscar ^{[4
]}

Russo, Paul ^{[24
]}

Scherr, Douglas S. ^{[21
]}

Shariat, Shahrokh F. ^{[25
]}

Spahn, Martin ^{[26
]}

Terrone, Carlo ^{[27
]}

Tilki, Derya ^{[3
]}

Vazquez-Martul, Dario ^{[11
]}

Vera Donoso, Cesar ^{[22
]}

Vergho, Daniel ^{[26
]}

Wallen, Eric M. ^{[23
]}

Zigeuner, Richard ^{[12
]}

机构：

[1] Univ Med Ctr Mainz, Dept Urol & Pediat Urol, Langenbeckstr 1, D-55131 Mainz, Germany

[2] USC, Norris Comprehens Canc Ctr, Los Angeles, CA USA

[3] Univ Calif Davis, Med Ctr, Dept Urol, Sacramento, CA 95817 USA

[4] Fundacio Puigvert, Dept Urol, Barcelona, Spain

[5] Hosp Univ Puerta Hierro Majadahonda, Dept Urol, Madrid, Spain

[6] Emory Univ, Dept Urol, Atlanta, GA 30322 USA

[7] Columbia Univ Coll Phys & Surg, Dept Urol, New York, NY 10032 USA

[8] Lahey Clin Fdn, Dept Urol, Burlington, MA USA

[9] Univ Vita Salute, Hosp San Raffaele, Dept Urol, Milan, Italy

[10] Univ Autonoma Madrid, Hosp Univ Puerta Hierro Majadahonda, Dept Urol, Madrid, Spain

[11] Complejo Hosp Univ A Coruna, Dept Urol, Coruna, Spain

[12] Med Univ Graz, Dept Urol, Graz, Austria

[13] Univ Miami, Miami Transplant Inst, Miami, FL USA

[14] Univ Turin, Dept Urol, AOU San Giovanni Battista, Turin, Italy

[15] Hosp Cent Cruz Roja San Jose & Santa Adela, Dept Urol, Madrid, Spain

[16] Heidelberg Univ, Dept Urol, Heidelberg, Germany

[17] NYU, Sch Med, Dept Urol, New York, NY 10003 USA

[18] Oregon Hlth & Sci Univ, Dept Urol, Portland, OR 97201 USA

[19] Hosp Univ Infanta Sofa, Dept Urol, Madrid, Spain

[20] Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy

[21] Weill Cornell Med Ctr, Dept Urol, New York, NY USA

[22] Hosp Univ & Politecn La Fe, Valencia, Spain

[23] Univ N Carolina, Dept Urol, Chapel Hill, NC USA

[24] Mem Sloan Kettering Canc Ctr, Dept Surg, Urol Serv, New York, NY 10021 USA

[25] Med Univ Vienna, Dept Urol, Vienna, Austria

[26] Univ Wurzburg, Dept Urol, Wurzburg, Germany

[27] Univ Piemonte Orientale, Maggiore della Carita Hosp, Div Urol, Novara, Italy

来源：

JOURNAL OF SURGICAL ONCOLOGY | 2016年 / 114卷 / 06期

关键词：

venous tumor thrombus; renal cell carcinoma; thrombus consistency; cancer specific survival; CYTOREDUCTIVE NEPHRECTOMY; EXTENSION; IMPACT; MANAGEMENT; SURGERY; LEVEL; VEIN;

D O I：

10.1002/jso.24395

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort. Methods: The records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors. Results: VTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS. Conclusions: In the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. (C) 2016 Wiley Periodicals, Inc.

引用

页码：764 / 768

页数：5

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