Rene Mager1, Siamak Daneshmand2, Christopher P Evans3, Joan Palou4, Juan I Martínez-Salamanca11, Viraj A Master6, James M McKiernan7, John A Libertino8, Axel Haferkamp9, Axel Haferkamp9, Umberto Capitanio10, Joaquín A Carballido11, Venancio Chantada12, Thomas Chromecki13, Gaetano Ciancio14, Siamak Daneshmand2, Christopher P Evans3, Paolo Gontero15, Javier González16, Markus Hohenfellner17, William C Huang18, Theresa M Koppie19, John A Libertino8, Estefanía Linares Espinós20, Adam Lorentz6, Juan I Martínez-Salamanca11, Viraj A Master6, James M McKiernan7, Francesco Montorsi10, Giacomo Novara21, Padraic O'Malley22, Sascha Pahernik17, Joan Palou4, José Luis Pontones Moreno23, Raj S Pruthi24, Oscar Rodriguez Faba4, Paul Russo25, Douglas S Scherr22, Shahrokh F Shariat26, Martin Spahn27, Carlo Terrone28, Derya Tilki3, Dario Vázquez-Martul12, Cesar Vera Donoso23, Daniel Vergho27, Eric M Wallen24, Richard Zigeuner13. 1. Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany. rene.mager@unimedizin-mainz.de. 2. USC/Norris Comprehensive Cancer Center, Los Angeles, California. 3. Department of Urology, UC Davis Medical Center, Sacramento, California. 4. Department of Urology, Fundació Puigvert, Barcelona, Spain. 5. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain. 6. Department of Urology, Emory University, Atlanta, Georgia. 7. Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York. 8. Department of Urology, Lahey Clinic, Burlington, Massachusetts. 9. Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany. 10. Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy. 11. Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain. 12. Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain. 13. Department of Urology, Medical University of Graz, Graz, Austria. 14. Miami Transplant Institute, University of Miami, Miami, Florida. 15. Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy. 16. Department of Urology, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain. 17. Department of Urology, University of Heidelberg, Heidelberg, Germany. 18. Department of Urology, New York University School of Medicine, New York, New York. 19. Department of Urology, Oregon Health and Science University, Portland, Oregon. 20. Department of Urology, Hospital Universitario Infanta Sofía, Madrid, Spain. 21. Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy. 22. Department of Urology, Weill Cornell Medical Center, New York, New York. 23. Hospital Universitario y Politécnico La Fe, Valencia, Spain. 24. Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina. 25. Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York. 26. Department of Urology, Medical University of Vienna, Vienna, Austria. 27. Department of Urology, University of Würzburg, Würzburg, Germany. 28. Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy.
Abstract
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. J. Surg. Oncol. 2016;114:764-768.
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 RCCpatients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764-768.
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