Renal Cell Carcinoma With Inferior Vena Cava Involvement: Prognostic Effect of Tumor Thrombus Consistency on Cancer Specific Survival
Por:
Mager, R, Haferkamp, A, Capitanio, U, Carballido, JA, Chantada, V, Chromecki, T, Ciancio, G, Daneshmand, S, Evans, CP, Gontero, P, Gonzalez, J, Hohenfellner, M, Huang, WC, Koppie, TM, Libertino, JA, Espinos, EL, Lorentz, A, Martinez-Salamanca, JI, Master, VA, Mckiernan, JM, Montorsi, F, Novara, G, O'Malley, P, Pahernik, S, Palou, J, Moreno, JLP, Pruthi, RS, Faba, OR, Russo, P, Scherr, DS, Shariat, SF, Spahn, M, Terrone, C, Tilki, D, Vazquez-Martul, D, Donoso, CV, Vergho, D, Wallen, EM, Zigeuner, R
Publicada:
1 nov 2016
Resumen:
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.
Filiaciones:
Mager, R:
Univ Med Ctr Mainz, Dept Urol & Pediat Urol, Langenbeckstr 1, D-55131 Mainz, Germany
Haferkamp, A:
Univ Med Ctr Mainz, Dept Urol & Pediat Urol, Langenbeckstr 1, D-55131 Mainz, Germany
Capitanio, U:
Univ Vita Salute, Hosp San Raffaele, Dept Urol, Milan, Italy
Carballido, JA:
Univ Autonoma Madrid, Hosp Univ Puerta Hierro Majadahonda, Dept Urol, Madrid, Spain
Chantada, V:
Complejo Hosp Univ A Coruna, Dept Urol, Coruna, Spain
Chromecki, T:
Med Univ Graz, Dept Urol, Graz, Austria
Ciancio, G:
Univ Miami, Miami Transplant Inst, Miami, FL USA
Daneshmand, S:
USC, Norris Comprehens Canc Ctr, Los Angeles, CA USA
Evans, CP:
Univ Calif Davis, Med Ctr, Dept Urol, Sacramento, CA 95817 USA
Gontero, P:
Univ Turin, Dept Urol, AOU San Giovanni Battista, Turin, Italy
Gonzalez, J:
Hosp Cent Cruz Roja San Jose & Santa Adela, Dept Urol, Madrid, Spain
Hohenfellner, M:
Heidelberg Univ, Dept Urol, Heidelberg, Germany
Huang, WC:
NYU, Sch Med, Dept Urol, New York, NY 10003 USA
Koppie, TM:
Oregon Hlth & Sci Univ, Dept Urol, Portland, OR 97201 USA
Libertino, JA:
Lahey Clin Fdn, Dept Urol, Burlington, MA USA
Espinos, EL:
Hosp Univ Infanta Sofa, Dept Urol, Madrid, Spain
Lorentz, A:
Emory Univ, Dept Urol, Atlanta, GA 30322 USA
Martinez-Salamanca, JI:
Hosp Univ Puerta Hierro Majadahonda, Dept Urol, Madrid, Spain
Univ Autonoma Madrid, Hosp Univ Puerta Hierro Majadahonda, Dept Urol, Madrid, Spain
Master, VA:
Emory Univ, Dept Urol, Atlanta, GA 30322 USA
Mckiernan, JM:
Columbia Univ Coll Phys & Surg, Dept Urol, New York, NY 10032 USA
Montorsi, F:
Univ Vita Salute, Hosp San Raffaele, Dept Urol, Milan, Italy
Novara, G:
Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy
O'Malley, P:
Weill Cornell Med Ctr, Dept Urol, New York, NY USA
Pahernik, S:
Heidelberg Univ, Dept Urol, Heidelberg, Germany
Palou, J:
Fundacio Puigvert, Dept Urol, Barcelona, Spain
Moreno, JLP:
Hosp Univ & Politecn La Fe, Valencia, Spain
Pruthi, RS:
Univ N Carolina, Dept Urol, Chapel Hill, NC USA
Faba, OR:
Fundacio Puigvert, Dept Urol, Barcelona, Spain
Russo, P:
Mem Sloan Kettering Canc Ctr, Dept Surg, Urol Serv, New York, NY 10021 USA
Scherr, DS:
Weill Cornell Med Ctr, Dept Urol, New York, NY USA
Shariat, SF:
Med Univ Vienna, Dept Urol, Vienna, Austria
Spahn, M:
Univ Wurzburg, Dept Urol, Wurzburg, Germany
Terrone, C:
Univ Piemonte Orientale, Maggiore della Carita Hosp, Div Urol, Novara, Italy
Tilki, D:
Univ Calif Davis, Med Ctr, Dept Urol, Sacramento, CA 95817 USA
Vazquez-Martul, D:
Complejo Hosp Univ A Coruna, Dept Urol, Coruna, Spain
Donoso, CV:
Hosp Univ & Politecn La Fe, Valencia, Spain
Vergho, D:
Univ Wurzburg, Dept Urol, Wurzburg, Germany
Wallen, EM:
Univ N Carolina, Dept Urol, Chapel Hill, NC USA
Zigeuner, R:
Med Univ Graz, Dept Urol, Graz, Austria
Green Accepted
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