Outcome of surgery for patients with renal cell carcinoma and tumour thrombus in the era of modern targeted therapy. (2nd September 2016)

• Record Type: Journal Article
• Authors: Tornberg, Sara V.; Nisen, Harry; Visapää, Harri; Kilpeläinen, Tuomas P.; Järvinen, Riikka; Mirtti, Tuomas; Kantonen, Ilkka; Simpanen, Jarmo; Bono, Petri; Taari, Kimmo; Järvinen, Petrus
• Is Part Of: Scandinavian journal of urology. Volume 50:Number 5(2016)
• Page Start: 380
• Page End: 386
• Publication Date: 2016-09-02
• Subjects: Complications -- prognostic factors -- surgery -- renal cell carcinoma -- tumour thrombus; Urology -- Periodicals; 616.6
• DOI: 10.1080/21681805.2016.1217558
• Languages: English
• ISSNs: 2168-1805

Abstract

Abstract: Objective: This study evaluated the clinical outcome of patients with renal cell carcinoma (RCC) with tumour thrombus (TT) after surgical management. Materials and methods: In total, 142 consecutive RCC patients with TT who were operated on in Helsinki University Hospital between 2006 and 2014 were analysed. Eighty-eight (62%) of these patients had been operated on with radical intention and 54 (38%) with cytoreductive intention. A total of 73 patients (51%) received postoperative targeted therapy. The primary endpoint was cancer-specific survival (CSS). Results: The 5 year CSS for level of involvement of TT in the renal vein, subdiaphragmatic vena cava and supradiaphragmatic vena cava was 60% (81 patients), 43% (52 patients) and 51% (nine patients), respectively ( p = .42). The median CSS for lymph-node involvement was 63 months for patients with no lymph-node involvement but 10 months for patients with lymph-node involvement ( p < .01). The median CSS for metastasis status was 63 months for patients with no metastases compared with 18 months for patients with metastases ( p < .01). Among several factors examined, WHO performance status ( p = .04), tumour necrosis ( p = .05), presence of distant metastases ( p = .04) and tumour histology ( p = .05) were associated with CSS in the multivariate analysis. Conclusions: Operative treatment for RCC with TT is associated with good prognosis when there is no lymph-node involvement or distant metastases.