Impact of Microscopic Wall Invasion of the Renal Vein or Inferior Vena Cava on Cancer-specific Survival in Patients with Renal Cell Carcinoma and Tumor Thrombus: A Multi-institutional Analysis from the International Renal Cell Carcinoma-Venous Thrombus Consortium

Faba, Ó. Rodríguez; Linares, Estefanía; Tilki, Derya; Capitanio, Umberto; Evans, Christopher P.; Montorsi, Francesco; Martínez-Salamanca, Juan Ignacio; Libertino, John A.; Gontero, Paolo; Palou, Joan

doi:10.1016/j.euf.2017.01.009

Cited by 37 publications

(31 citation statements)

References 24 publications

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“…In our study, potential predictors, such as thrombus level and tumour necrosis, were not significantly associated with PFS or CSS. In contrast, most recent studies have supported the impact of thrombus level on oncologic outcomes in RCC with vena caval tumour thrombus [17,24,26], although some results are conflicting [27]. Currently, the prognostic significance of tumour necrosis is less certain.…”

Section: Discussionmentioning

confidence: 99%

“…A study based on 3017 cases of clear cell RCC showed that the WHO/ISUP grading system achieves a better predictive ability for prognosis when the presence of tumour necrosis is [28]. However, in several studies, tumour necrosis was not shown to be an independent predictor of oncologic outcomes [18,23,26]. Compared to the cytokine therapy era, the targeted therapy era has achieved significant improvement in survival in RCC.…”

Section: Discussionmentioning

confidence: 99%

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Impact of sarcomatoid differentiation and rhabdoid differentiation on prognosis for renal cell carcinoma with vena caval tumour thrombus treated surgically

Yang

et al. 2020

BMC Urol

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Background: Sarcomatoid differentiation in renal cell carcinoma (RCC) with vena caval tumour thrombus has been shown to be associated with aggressive behaviours and poor prognosis; however, evidence of the impact of rhabdoid differentiation on prognosis is lacking. This study evaluated the impact of sarcomatoid differentiation and rhabdoid differentiation on oncological outcomes for RCC with vena caval tumour thrombus treated surgically. Methods: We retrospectively analysed patients treated surgically for RCC with vena caval tumour thrombus at our institute from Jan 2015 to Nov 2018. Prognostic variables were evaluated for associations with progression-free survival (PFS) and cancer-specific survival (CSS) by Kaplan-Meier survival analysis and log-rank test. Univariate and multivariate analyses were performed to determine independent prognostic variables. Results:We identified 125 patients with RCC and vena caval tumour thrombus, including 17 (13.6%) with sarcomatoid differentiation alone, 8 (6.4%) with rhabdoid differentiation alone and 3 (2.4%) with both sarcomatoid and rhabdoid differentiation. Compared to pure RCC, patients with sarcomatoid differentiation but not rhabdoid differentiation have worse PFS (p = 0.018 and p = 0.095, respectively). The univariate and multivariate analyses both showed sarcomatoid differentiation as a significant predictor of PFS. Compared to pure RCC, patients with sarcomatoid differentiation (p = 0.002) and rhabdoid differentiation (p = 0.001) both had significantly worse CSS. The univariate analysis showed sarcomatoid differentiation, rhabdoid differentiation, metastasis and blood transfusion as significant predictors of CSS (All, p < 0.05). In the multivariate analysis, sarcomatoid differentiation (HR 3.90, p = 0.008), rhabdoid differentiation (HR 3.01, p = 0.042), metastasis (HR 3.87, p = 0.004) and blood transfusion (HR 1.34, p = 0.041) all remained independent predictors of CSS.Conclusions: Sarcomatoid differentiation and rhabdoid differentiation are both independent predictors of poor prognosis in RCC with vena caval tumour thrombus treated surgically.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of sarcomatoid differentiation and rhabdoid differentiation on prognosis for renal cell carcinoma with vena caval tumour thrombus treated surgically

Yang

et al. 2020

BMC Urol

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“…IVC wall invasion has been described in up to 23% of in cases with tumoral venous extension. It is a known negative prognostic factor, upgrading RCC to a stage T3c according to the American Joint Committee on Cancer (AJCC) classification, independent of the cranial extent of the thrombus [6]. This subgroup harbors a 10-year cancer specific survival rate of 25% for which microscopic IVC wall invasion is an important predictive factor [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…It is a known negative prognostic factor, upgrading RCC to a stage T3c according to the American Joint Committee on Cancer (AJCC) classification, independent of the cranial extent of the thrombus [6]. This subgroup harbors a 10-year cancer specific survival rate of 25% for which microscopic IVC wall invasion is an important predictive factor [6,7]. Positive vascular wall margins following surgery result in significantly shorter recurrence free intervals (22 versus 70 months) [8].…”

Section: Introductionmentioning

confidence: 99%

The Value of Multiparametric MRI for Assessment of Inferior Vena Cava Wall Invasion by Renal Cell Carcinoma Thrombus: A Prospective Feasibility Study

et al. 2019

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Background: Renal cell carcinoma (RCC) thrombus invasion in the inferior vena cava (IVC) wall needs adequate resection to improve survival. Surgical planning to avoid positive vascular surgical margins and recurrent disease can be facilitated by imaging capable of diagnosing this invasion and the extent of the thrombus. Objective: To evaluate the diagnostic performance of multiparametric MR imaging (mpMRI) for detecting inferior vena cava (IVC) wall invasion and extent of renal cell carcinoma (RCC) thrombus. Methods: In this prospective study, twenty consecutive patients underwent mpMRI before open radical nephrectomy with IVC thrombectomy was performed in a single high-volume institution by one urologist (PM) blinded for mpMRI findings. Primary endpoint was mpMRI negative-and positive predictive value (NPV/PPV) for IVC wall invasion as encountered during surgery. IVC wall invasion was assessed on mpMRI by a radiologist prior to the surgery based on qualitative imaging parameters. Also, NPV and PPV were calculated with incremental use of quantitative parameters. Therefore, the association between IVC wall invasion and the maximum IVC and renal vein orifice diameter, and the cranial extent of the thrombus was evaluated by logistic regression. After ROC analysis an optimal cutoff point was selected for significantly associated quantitative parameters. NPV and PPV were calculated using this optimal cutoff point. Results: mpMRI NPV and PPV for IVC wall invasion based on qualitative parameters was 82% and 100%, respectively. An increase in IVC diameter was significantly associated with IVC wall invasion (p < 0.05). With incremental use of an IVC diameter cutoff value of 27 mm NPV and PPV for IVC wall invasion were 100% and 89%, respectively. Conclusion: mpMRI is able to reliably diagnose IVC wall invasion of RCC thrombus and can optimize radical surgical resection.

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“…Õàðàêòåðíîþ îñîáëèâ³ñòþ ÍÊÐ º ôîðìóâàííÿ ïóõëèííèõ òðîìá³â ç ïîäàëüøèì ¿õ ïîøèðåííÿì ó íèaeíþ ïîðîaeíèñòó âåíó (ÍÏÂ) ó 4-10% âèïàäê³â, ³íîä³ -íàâ³òü äî ïðàâîãî ïåðåäñåðäÿ [9,30,41,45,47,48,55,56]. ×àñòîòà 5-ð³÷íîãî âèaeèâàííÿ õâîðèõ íà ÍÊÐ, óñêëàäíåíèé âåíîçíèì ïîøèðåííÿì, ïðè â³äñóòíîñò³ â³ääàëåíèõ ìåòàñòàç³â ñòàíîâèòü 40-69%, à âíóòð³øíüîâåíîçíå ðîçïîâñþäaeåííÿ íå º êðèòåð³ºì äèñåì³-íàö³¿ ïóõëèííîãî ïðîöåñó ó ï³ñëÿîïåðàö³éíîìó ïåð³îä³ [4,16,34,47,51]. Òîìó, ðàäèêàëüíà íå-ôðåêòîì³ÿ ç êàâàòðîìáåêòîì³ºþ çàëèøàþòüñÿ ìåòîäîì âèáîðó ë³êóâàííÿ äàíî¿ êàòåãîð³¿ ïàö³-ºíò³â [2,5,7,9,11,15,16,25,34,41,52,55].…”

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Renal cell carcinoma, complicated by thrombosis of the inferior vena cava and the right atrium

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2018

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Ìåòà. Ïðîàíàë³çóâàòè ñó÷àñí³ ïîãëÿäè íà àêòóàëüí³ñòü, îñîáëèâîñò³ êëàñèô³êàö³¿, êë³í³÷íîãî ïåðåá³ãó, ä³à´íîñòèêè òà ë³êóâàííÿ íèðêîâî-êë³òèííîãî ðàêó, óñêëàäíåíîãî òðîìáîçîì íèaeíüî¿ ïîðîaeíèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Ìàòåð³àë ³ ìåòîäè. Ïðîâåäåíî àíàë³ç ïóáë³êàö³é çà ïåð³îä 2004-2017 ðîê³â. Â³ä³áðàíî 57 ïåðøîäaeåðåë, ÿê³ â³äîáðàaeàþòü àêòóàëüí³ñòü, îñîáëèâîñò³ êëàñèô³êàö³¿, êë³-í³÷íîãî ïåðåá³ãó, ä³à´íîñòèêè òà ë³êóâàííÿ íèðêîâî-êë³òèííîãî ðàêó, óñêëàäíåíîãî òðîìáîçîì íèaeíüî¿ ïîðîae-íèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Ðåçóëüòàòè é îáãîâîðåííÿ. Õàðàêòåðíîþ îñîáëèâ³ñòþ íèðêîâî-êë³òèííîãî ðàêó º ñõèëüí³ñòü äî ñóäèííî¿ ³íâàç³¿ ç ôîðìóâàííÿì ïóõëèííèõ òðîìá³â ó íèðêîâ³é òà íèaeí³é ïîðîaeíèñò³é âåíàõ ó 4-10% âèïàäê³â, ³íîä³ -ç ïîøèðåííÿì ó ïðàâå ïåðåäñåðäÿ. ×àñòîòà 5-ð³÷íîãî âèaeèâàííÿ õâîðèõ íà íèðêîâî-êë³òèííèé ðàê, óñêëàäíåíèé âåíîçíèì ïîøèðåííÿì, ïðè â³äñóòíîñò³ â³ääàëåíèõ ìåòàñòàç³â ñòàíîâèòü 40-69%, à âíóòð³øíüîâåííå ðîçïîâñþäaeåííÿ íå º êðèòåð³ºì äèñåì³íàö³¿ ïóõëèííîãî ïðîöåñó ó ï³ñëÿ-îïåðàö³éíîìó ïåð³îä³. Òîìó, ðàäèêàëüíà íåôðåêòîì³ÿ ç êàâàòðîìáåêòîì³ºþ çàëèøàþòüñÿ îñíîâíèì ìåòîäîì ë³êóâàííÿ äàíî¿ êàòå´îð³¿ ïàö³ºíò³â. Íåçâàaeàþ÷è íà óäîñêîíàëåííÿ ìåòîäèê êàâàòðîìáåêòîì³¿, õ³ðóð´³÷íå ë³êóâàííÿ ïðîäîâaeóº çàëèøàòèñÿ òåõí³÷íî ñêëàäíèì, àñî-ö³þþ÷èñü ç âèñîêîþ ÷àñòîòîþ óñêëàäíåíü òà ëåòàëü-íîñò³, îñîáëèâî, ïðè âèäàëåíí³ ïóõëèííèõ òðîìá³â ðåò-ðîïå÷³íêîâîãî, íàää³àôðàãìàëüíîãî â³ää³ë³â íèaeíüî¿ ïî-ðîaeíèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Âêðàé âàaeëèâèìè äëÿ áåçïå÷íîãî âèäàëåííÿ ïóõëèííîãî òðîìáó º ïå-ðåäîïåðàö³éíà îö³íêà ñòóïåíþ ïîøèðåíîñò³ íåîïðîöåñó, íàÿâíîñò³ ³íâàç³¿ âåíîçíî¿ ñò³íêè, ñòàíó ïå÷³íêîâèõ âåí (ñèíäðîì Áàääà-Ê³àð³), îïòèìàëüíà ïðîô³ëàêòèêà òðîì-áîåìáîë³÷íèõ òà ãåìîðàã³÷íèõ óñêëàäíåíü. Âèñíîâêè. Ðàäèêàëüíà õ³ðóð´³ÿ çàëèøàºòüñÿ ìåòîäîì âèáîðó ë³êóâàííÿ íèðêîâî-êë³òèííîãî ðàêó, óñêëàäíåíîãî òðîìáîçîì íèaeíüî¿ ïîðîaeíèñòî¿ âåíè òà ïðàâîãî ïåðåäñåðäÿ. Ïðîâåäåíèé àíàë³ç ë³òåðàòóðíèõ äaeåðåë äàº ï³äñòàâè ñòâåðäaeóâàòè ïðî âèñîêó åôåêòèâí³ñòü ðà-äèêàëüíî¿ íåôðåêòîì³¿ ó ïîºäíàíí³ ç êàâàòðîìáåêòîì³ºþ, ÿêà çóìîâëåíà ñâîº÷àñíîþ ä³à´íîñòèêîþ ïîøèðåíîñ-ò³ íåîïðîöåñó, óäîñêîíàëåííÿì òàêòèêè õ³ðóð´³÷íîãî ë³êóâàííÿ, îïòèìàëüíîþ ïðîô³ëàêòèêîþ âàaeêèõ ãåìîðà-ã³÷íèõ òà òðîìáîåìáîë³÷íèõ óñêëàäíåíü, ùî â ñâîþ ÷åðãó çàáåçïå÷óº çàäîâ³ëüí³ â³ääàëåí³ ðåçóëüòàòè. Êëþ÷îâ³ ñëîâà: íèðêîâî-êë³òèííèé ðàê, ïóõëèííèé òðîìá, íèaeíÿ ïîðîaeíèñòà âåíà, ïðàâå ïåðåäñåðäÿ, ä³-à´íîñòèêà, ë³êóâàííÿ ÍÈÐÊÎÂÎ-ÊË²ÒÈÍÍÈÉ ÐÀÊ, ÓÑÊËÀÄÍÅÍÈÉ ÒÐÎÌÁÎÇÎÌ ÍÈAEÍÜÎ¯ ÏÎÐÎAEÍÈÑÒÎ¯ ÂÅÍÈ ÒÀ ÏÐÀÂÎÃÎ ÏÅÐÅÄÑÅÐÄß Êîáçà ².²., Ìîòà Þ.Ñ. Ëüâ³âñüêèé íàö³îíàëüíèé ìåäè÷íèé óí³âåðñèòåò ³ìåí³ Äàíèëà Ãàëèöüêîãî Êàôåäðà õ³ðóð´³¿ ¹ 2 (çàâ. -ïðîô. ².². Êîáçà) Aim. To analyze the contemporary views of the relevance, features of classification, clinical course, diagnosis and treatment of renal cell carcinoma, complicated by thrombosis of the inferior vena cava and the right atrium. Material and Methods. The publications on the topic over the period of 2004-2017 were analyzed. Fifty-seven primary sources were selected, reflecting the relevance, features of classification, clinic...

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Impact of Microscopic Wall Invasion of the Renal Vein or Inferior Vena Cava on Cancer-specific Survival in Patients with Renal Cell Carcinoma and Tumor Thrombus: A Multi-institutional Analysis from the International Renal Cell Carcinoma-Venous Thrombus Consortium

Cited by 37 publications

References 24 publications

Impact of sarcomatoid differentiation and rhabdoid differentiation on prognosis for renal cell carcinoma with vena caval tumour thrombus treated surgically

Impact of sarcomatoid differentiation and rhabdoid differentiation on prognosis for renal cell carcinoma with vena caval tumour thrombus treated surgically

The Value of Multiparametric MRI for Assessment of Inferior Vena Cava Wall Invasion by Renal Cell Carcinoma Thrombus: A Prospective Feasibility Study

Renal cell carcinoma, complicated by thrombosis of the inferior vena cava and the right atrium

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