Predictors of Survival in Patients Undergoing Surgery for Renal Cell Carcinoma and Inferior Vena Cava Tumor Thrombus

Pieretti, Alberto; Ozambela, Manuel; Westerman, Mary E.; Nogueras‐González, Graciela M.; Segarra, Luis A.; Zacharias, Nikolaos; Vaporciyan, Ara A.; Hofstetter, Wayne L.; Huynh, Tam T.; Aldousari, Saad; Peng, Jiaqi; Karam, Jose A.

doi:10.1016/j.clgc.2022.02.001

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…The effectiveness of presurgery therapy for patients with RCC and IVC is not well supported by evidence [ 10 ]. A prospective trial investigating the effectiveness of sorafenib or sunitinib after surgery for non-metastatic RCC with IVC tumor thrombus did not find any improvement in overall survival, but found improved disease free survival [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous surgical management of renal cancer with atrial thrombotic extension and severe chronic coronary artery disease: a case report

Filomena,

Marino,

Scarciglia

et al. 2023

J Med Case Reports

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Background Renal cell carcinoma accounts for 2–3% of all malignant cancers in adults and is characterized by the potential development of venous tumor thrombus. Case presentation We present a rare case of a 62-year-old Caucasian man who arrived in the emergency department for monosymptomatic hematuria. Further investigation revealed a right renal cell carcinoma with 16 cm intravascular extension through the renal vein into the inferior vena cava and right atrium associated with significant coronary artery disease based on the computed tomography scan and coronary angiography. To the best of our knowledge, after an extensive literature review, only one similar case has been reported with involvement of the contralateral kidney. Therefore, there are no applicable management recommendations. After performing coronary artery bypass graft surgery, we proceeded with an open right radical nephrectomy and inferior vena cava and right atrium thrombectomy under cardiopulmonary bypass and while the patient’s heart was still beating. The postoperative course went without complications, and the patient was discharged from the hospital on the 10th postoperative day. Conclusions Radical nephrectomy and thrombectomy with reconstruction of the inferior vena cava combined with coronary artery bypass graft can be performed safely and effectively in selected patients with renal cell carcinoma and significant coronary artery disease. Multidisciplinary teamwork and careful patient selection are essential for optimal outcomes.

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Section: Discussionmentioning

confidence: 99%

Simultaneous surgical management of renal cancer with atrial thrombotic extension and severe chronic coronary artery disease: a case report

Filomena,

Marino,

Scarciglia

et al. 2023

J Med Case Reports

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show abstract

“…The primary tumor invades the venous system and forms a renal vein or inferior vena cava thrombus in approximately 4–15% of RCC patients 1 , 2 . As venous tumor thrombus (VTT) is a potentially key initial stage of metastatic ccRCC, patients with VTT exhibit poor prognosis if left untreated, with a median survival of 5 months, and a 1-year disease-specific survival rate of 29% 3 , 4 . Although advances in surgical management have improved the survival rate among ccRCC patients with VTT 5 , the challenges of postoperative complications and perioperative mortality remain, and limited preoperative clinical benefit is derived from targeted therapy 6 .…”

Section: Introductionmentioning

confidence: 99%

Integrative transcriptome and proteome analyses of clear cell renal cell carcinoma develop a prognostic classifier associated with thrombus

Shi,

Pang,

Nian

et al. 2023

Sci Rep

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Clear cell renal cell carcinoma (ccRCC) with venous tumor thrombus (VTT) is associated with poor prognosis. Our integrative analyses of transcriptome and proteome reveal distinctive molecular features of ccRCC with VTT, and yield the development of a prognostic classifier to facilitate ccRCC molecular subtyping and treatment. The RNA sequencing and mass spectrometry were performed in normal-tumor-thrombus tissue triples of five ccRCC patients. Statistical analysis, GO and KEGG enrichment analysis, and protein–protein interaction network construction were used to interpret the transcriptomic and proteomic data. A six-gene-based classifier was developed to predict patients’ survival using Cox regression, which was validated in an independent cohort. Transcriptomic analysis identified 1131 tumorigenesis-associated differentially expressed genes (DEGs) and 856 invasion-associated DEGs. Overexpression of transcription factor EGR2 in VTT indicated its important role in tumor invasion. Furthermore, proteomic analysis showed 597 tumorigenesis-associated differentially expressed proteins (DEPs) and 452 invasion-associated DEPs. The invasion-associated DEPs showed unique enrichment in DNA replication, lysine degradation, and PPAR signaling pathway. Integration of transcriptome and proteome reveals 142 tumorigenesis-associated proteins and 84 invasion-associated proteins displaying changes consistent with corresponding genes in transcriptomic profiling. Based on their different expression patterns among normal-tumor-thrombus triples, RAB25 and GGT5 were supposed to play a consistent role in both tumorigenesis and invasion processes, while SHMT2 and CADM4 might play the opposite roles in tumorigenesis and thrombus invasion. A prognostic classifier consisting of six DEGs (DEPTOR, DPEP1, NAT8, PLOD2, SLC7A5, SUSD2) performed satisfactorily in predicting survival of ccRCC patients (HR = 4.41, P < 0.001), which was further validated in an independent cohort of 40 cases (HR = 5.52, P = 0.026). Our study revealed the transcriptomic and proteomic profiles of ccRCC patients with VTT, and identified the distinctive molecular features associated with VTT. The six-gene-based prognostic classifier developed by integrative analyses may facilitate ccRCC molecular subtyping and treatment.

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Age Does Not Impact Cancer Specific Mortality: From Sub-Distributional and Cause-Specific Hazard Analysis in RCC Patients Undergoing Radical Nephrectomy and Thrombectomy

Kim,

Gwon,

Lee

et al. 2024

Clinical Genitourinary Cancer

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Predictors of Survival in Patients Undergoing Surgery for Renal Cell Carcinoma and Inferior Vena Cava Tumor Thrombus

Cited by 5 publications

References 23 publications

Simultaneous surgical management of renal cancer with atrial thrombotic extension and severe chronic coronary artery disease: a case report

Simultaneous surgical management of renal cancer with atrial thrombotic extension and severe chronic coronary artery disease: a case report

Integrative transcriptome and proteome analyses of clear cell renal cell carcinoma develop a prognostic classifier associated with thrombus

Age Does Not Impact Cancer Specific Mortality: From Sub-Distributional and Cause-Specific Hazard Analysis in RCC Patients Undergoing Radical Nephrectomy and Thrombectomy

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