OBJECTIVES: To identify the prognostic impact of venous tumor thrombus in locally-advanced renal cell carcinomas (RCC).
To further differentiate the clinical course of patients with VTT despite similar clinicopathological characteristics.
PATIENTS AND METHODS: Determination of the VTT consistency (solid vs. friable) and the correlation with clinical and pathological parameters. A retrospective cohort of 200 RCC patients nephrectomized between 1994 and 2011.
RESULTS: 65% with a solid VTT, 35% with friable VTT which demonstrates a significant decrease in cell-cell adhesion molecules and connective tissue. Correlation of a friable VTT with advanced pT-stage, higher VTT level, papillary RCC subtype, and a lower age. Significantly shorter median overall survival of patients with a friable, than in patients with a solid VTT (29 vs. 89 months), but failure of VTT consistency as an independent predictor of patients' survival in the multivariate Cox analysis VTT consistency as an independent significant predictor of overall survival in patients without evidence of distant and nodal metastases (n=119).
CONCLUSION: VTT consistency caused by the tumor and not different surgical handling. A friable VTT as an important adverse prognostic predictor of overall survival in patients with non-metastatic RCC.
Written by:
Weiss VL, Braun M, Perner S, Harz A, Vorreuther R, Kristiansen G, Müller SC, Ellinger J. Are you the author?
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum, Bonn, Bonn, Germany.
Reference: BJU Int. 2013 Jun 20. Epub ahead of print.
doi: 10.1111/bju.12322
PubMed Abstract
PMID: 24053185
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