This study evaluated the clinical outcome of patients with renal cell carcinoma (RCC) with tumour thrombus (TT) after surgical management.
In total, 142 consecutive RCC patients with TT who were operated on in Helsinki University Hospital between 2006 and 2014 were analysed. Eighty-eight (62%) of these patients had been operated on with radical intention and 54 (38%) with cytoreductive intention. A total of 73 patients (51%) received postoperative targeted therapy. The primary endpoint was cancer-specific survival (CSS).
The 5 year CSS for level of involvement of TT in the renal vein, subdiaphragmatic vena cava and supradiaphragmatic vena cava was 60% (81 patients), 43% (52 patients) and 51% (nine patients), respectively (p = .42). The median CSS for lymph-node involvement was 63 months for patients with no lymph-node involvement but 10 months for patients with lymph-node involvement (p < .01). The median CSS for metastasis status was 63 months for patients with no metastases compared with 18 months for patients with metastases (p < .01). Among several factors examined, WHO performance status (p = .04), tumour necrosis (p = .05), presence of distant metastases (p = .04) and tumour histology (p = .05) were associated with CSS in the multivariate analysis.
Operative treatment for RCC with TT is associated with good prognosis when there is no lymph-node involvement or distant metastases.
Scandinavian journal of urology. 2016 Oct [Epub]
Sara V Tornberg, Harry Nisen, Harri Visapää, Tuomas P Kilpeläinen, Riikka Järvinen, Tuomas Mirtti, Ilkka Kantonen, Jarmo Simpanen, Petri Bono, Kimmo Taari, Petrus Järvinen
a Department of Urology , Helsinki University Hospital , Helsinki , Finland ;, b University of Helsinki , Faculty of Medicine , Helsinki , Finland ;