The Adverse Survival Implications of Bland Thrombus in Renal Cell Carcinoma With Venous Tumor Thrombus

To characterize the presence of bland (nontumor) thrombus in advanced renal cell carcinoma and assess the impact of this finding on cancer-specific survival. A multi-institutional database of patients treated with nephrectomy with caval thrombectomy for locally-advanced renal tumors was assembled fr...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2018-05, Vol.115, p.119-124
Main Authors: Hutchinson, Ryan, Rew, Charles, Chen, Gong, Woldu, Solomon, Krabbe, Laura-Maria, Meissner, Matthew, Sheth, Kunj, Singla, Nirmish, Shakir, Nabeel, Master, Viraj A., Karam, Jose A., Matin, Surena F., Borregales, Leonardo D., Wood, Christopher, Masterson, Timothy, Thompson, R. Houston, Boorjian, Stephen A., Leibovich, Bradley C., Abel, E. Jason, Bagrodia, Aditya, Margulis, Vitaly
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Renal Cell - complications
Carcinoma, Renal Cell - secondary
Carcinoma, Renal Cell - surgery
Female
Humans
Kidney Neoplasms - complications
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Grading
Neoplasm Staging
Neoplastic Cells, Circulating - pathology
Nephrectomy
Survival Rate
Thrombectomy
Thrombosis - complications
Thrombosis - surgery
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Summary:To characterize the presence of bland (nontumor) thrombus in advanced renal cell carcinoma and assess the impact of this finding on cancer-specific survival. A multi-institutional database of patients treated with nephrectomy with caval thrombectomy for locally-advanced renal tumors was assembled from 5 tertiary care medical centers. Using clinicopathologic variables including patient age, body mass index, Eastern Cooperative Oncology Group performance status, tumor stage, grade, nodal status and histology, and nearest-neighbor and multiple-matching propensity score matched cohorts of bland thrombus vs nonbland thrombus patients were assessed. Multivariable analysis for predictors of cancer-specific survival was performed. From an initial cohort of 579 patients, 446 met inclusion criteria (174 with bland thrombus, 272 without). At baseline, patients with bland thrombus had significantly worse performance status, higher tumor stage, higher prevalence of regional nodal metastases and higher nuclear grade (P 
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2018.02.019