OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7%), II for 10 (72%) and III (21%) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43%) patients had a measurable decrease, 6 (43%) had no change, and 2 (14%) had an increase in the thrombus. One patient (7%) had a downstage of thrombus level, 12 (85%) had stable thrombi, and 1 (7%) had an upstage. Regarding primary tumor, 7 (50%), 5 (36%) and 2 (14%) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi.
OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7%), II for 10 (72%) and III (21%) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43%) patients had a measurable decrease, 6 (43%) had no change, and 2 (14%) had an increase in the thrombus. One patient (7%) had a downstage of thrombus level, 12 (85%) had stable thrombi, and 1 (7%) had an upstage. Regarding primary tumor, 7 (50%), 5 (36%) and 2 (14%) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi.
Authors: Thomas Horn; Mark K Thalgott; Tobias Maurer; Katharina Hauner; Stephan Schulz; Alexander Fingerle; Margitta Retz; Jürgen E Gschwend; Hubert R Kübler Journal: Anticancer Res Date: 2012-05 Impact factor: 2.480
Authors: Inga Peters; Michael Winkler; Björn Jüttner; Omke E Teebken; T R Herrmann; Christoph von Klot; Mario Kramer; Angela Reichelt; Mahmoud Abbas; Markus A Kuczyk; Axel S Merseburger Journal: World J Urol Date: 2012-09-30 Impact factor: 4.226
Authors: Nicholas G Cost; Scott E Delacroix; Joshua P Sleeper; Paul J Smith; Ramy F Youssef; Brian F Chapin; Jose A Karam; Stephen Culp; E Jason Abel; James Brugarolas; Ganesh V Raj; Arthur I Sagalowsky; Christopher G Wood; Vitaly Margulis Journal: Eur Urol Date: 2011-02-23 Impact factor: 20.096
Authors: Brian F Chapin; Scott E Delacroix; Stephen H Culp; Graciela M Nogueras Gonzalez; Nizar M Tannir; Eric Jonasch; Pheroz Tamboli; Christopher G Wood Journal: Eur Urol Date: 2011-05-25 Impact factor: 20.096
Authors: Thomas Powles; Naveed Sarwar; Rob Jones; Peter Wilson; Ekaterini Boleti; Andrew Protheroe; Simon J Crabb; Jonathan Shamash; Andrew Stockdale; Sukaina Rashid; Paul Nathan; Simon Chowdury Journal: Eur J Cancer Date: 2012-07-04 Impact factor: 9.162
Authors: Erica H Lambert; Phillip M Pierorazio; Ahmad Shabsigh; Carl A Olsson; Mitchell C Benson; James M McKiernan Journal: Urology Date: 2007-06 Impact factor: 2.649
Authors: Anil A Thomas; Brian I Rini; Brian R Lane; Jorge Garcia; Robert Dreicer; Eric A Klein; Andrew C Novick; Steven C Campbell Journal: J Urol Date: 2008-12-18 Impact factor: 7.450
Authors: Javier Puente Vázquez; T Alonso Gordoa; J Moreno; L Poma; E Diaz Rubio; A Gomez; J Blazquez; J L Gonzalez Larriba Journal: Curr Treat Options Oncol Date: 2015-03
Authors: Sebastien J Hotte; Anil Kapoor; Naveen S Basappa; Georg Bjarnason; Christina Canil; Henry J Conter; Piotr Czaykowski; Jeffrey Graham; Samantha Gray; Daniel Y C Heng; Pierre I Karakiewicz; Christian Kollmannsberger; Aly-Khan A Lalani; Scott A North; François Patenaude; Denis Soulières; Phillippe Violette; Eric Winquist; Lori A Wood; Shaan Dudani; Ranjena Maloni; M Neil Reaume Journal: Can Urol Assoc J Date: 2019-10 Impact factor: 1.862