Literature DB >> 21795070

Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus.

Jared M Whitson1, Adam C Reese, Maxwell V Meng.   

Abstract

OBJECTIVES: To identify prognostic factors for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and determine the significance of thrombus level on survival.
MATERIALS AND METHODS: Patients within the Surveillance, Epidemiology, and End Results (SEER) database with RCC and VTT were identified and included if managed surgically. The Kaplan-Meier method and Cox regression analyses were performed to identify factors associated with disease-specific survival.
RESULTS: A total of 1,875 patients met the inclusion criteria. One-year survival for patients undergoing surgery was 60% for patients with metastases and 90% for those without. Factors associated with worse survival included larger tumor size (HR 1.2, 95% CI 1.0-1.4), medullary, collecting duct, or sarcomatoid histology (HR 2.2, 95% CI 1.5-3.3), Fuhrman grade 3 (HR 2.2, 95% CI 1.5-3.3) or grade 4 (HR 2.9, 95% CI 1.8-4.5) tumors, positive lymph nodes (HR 1.5, 95% CI 1.0-2.0), and metastases (HR 3.5, 95% CI 2.6-4.8). Thrombus level above the diaphragm (T3c) was not significantly associated with worse survival (HR 1.4, 95% CI 0.8-2.5).
CONCLUSIONS: In this large, population-based study of patients with RCC and VTT, we identify several disease-specific factors strongly associated with cancer-specific mortality. After controlling for adverse prognostic factors, thrombus level was not associated with worse outcome.
Copyright © 2013 Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21795070     DOI: 10.1016/j.urolonc.2010.11.017

Source DB:  PubMed          Journal:  Urol Oncol        ISSN: 1078-1439            Impact factor:   3.498


  11 in total

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