Prognostic Risk Stratification and Clinical Outcomes in Patients Undergoing Surgical Treatment for Renal Cell Carcinoma with Vascular Tumor Thrombus

Erica H. Lambert, Phillip Martin Pierorazio, Ahmad Shabsigh, Carl A. Olsson, Mitchell C. Benson, James M. McKiernan

Research output: Contribution to journalArticle

Abstract

Objectives: Approximately 4% to 10% of patients with renal cell carcinoma (RCC) present with vascular tumor thrombus. Often, these patients also present with metastatic disease. This study examined the clinical outcome and morbidity of patients with RCC and vascular tumor thrombus treated with aggressive surgical therapy. Methods: From 1989 to 2006, 118 patients were identified with Stage pT3b or pT3c RCC who had undergone radical nephrectomy and thrombectomy. Disease-specific survival (DSS) and overall survival were measured by Kaplan-Meier statistics with the log-rank test to assess differences in survival stratified by the clinical and pathologic variables. Cox regression techniques were used to identify significant predictors of DSS. Results: The median follow-up was 18 months (range 1 month to 13.55 years). Tumor thrombus was at the level of the renal vein in 67 patients (56.8%), the infradiaphragmatic inferior vena cava in 39 (33%), and the supradiaphragmatic inferior vena cava in 12 patients (10%). Of the 118 patients, 42 (35.6%) presented with metastasis. The median tumor size was 8.2 cm. The 5-year overall survival rate was 40.7%. The 5-year DSS rate was 60.3% in those without metastasis and 10% in those with metastasis (P

Original languageEnglish (US)
Pages (from-to)1054-1058
Number of pages5
JournalUrology
Volume69
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

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Renal Cell Carcinoma
Blood Vessels
Thrombosis
Neoplasms
Survival
Inferior Vena Cava
Neoplasm Metastasis
Therapeutics
Survival Rate
Thrombectomy
Renal Veins
Nephrectomy
Morbidity

ASJC Scopus subject areas

  • Urology

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Prognostic Risk Stratification and Clinical Outcomes in Patients Undergoing Surgical Treatment for Renal Cell Carcinoma with Vascular Tumor Thrombus. / Lambert, Erica H.; Pierorazio, Phillip Martin; Shabsigh, Ahmad; Olsson, Carl A.; Benson, Mitchell C.; McKiernan, James M.

In: Urology, Vol. 69, No. 6, 06.2007, p. 1054-1058.

Research output: Contribution to journalArticle

Lambert, Erica H. ; Pierorazio, Phillip Martin ; Shabsigh, Ahmad ; Olsson, Carl A. ; Benson, Mitchell C. ; McKiernan, James M. / Prognostic Risk Stratification and Clinical Outcomes in Patients Undergoing Surgical Treatment for Renal Cell Carcinoma with Vascular Tumor Thrombus. In: Urology. 2007 ; Vol. 69, No. 6. pp. 1054-1058.
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AU - Benson, Mitchell C.

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AB - Objectives: Approximately 4% to 10% of patients with renal cell carcinoma (RCC) present with vascular tumor thrombus. Often, these patients also present with metastatic disease. This study examined the clinical outcome and morbidity of patients with RCC and vascular tumor thrombus treated with aggressive surgical therapy. Methods: From 1989 to 2006, 118 patients were identified with Stage pT3b or pT3c RCC who had undergone radical nephrectomy and thrombectomy. Disease-specific survival (DSS) and overall survival were measured by Kaplan-Meier statistics with the log-rank test to assess differences in survival stratified by the clinical and pathologic variables. Cox regression techniques were used to identify significant predictors of DSS. Results: The median follow-up was 18 months (range 1 month to 13.55 years). Tumor thrombus was at the level of the renal vein in 67 patients (56.8%), the infradiaphragmatic inferior vena cava in 39 (33%), and the supradiaphragmatic inferior vena cava in 12 patients (10%). Of the 118 patients, 42 (35.6%) presented with metastasis. The median tumor size was 8.2 cm. The 5-year overall survival rate was 40.7%. The 5-year DSS rate was 60.3% in those without metastasis and 10% in those with metastasis (P

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