The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus

Abstract

To cite this article: Ihaddadene R, Yokom DW, Le Gal G, Moretto P, Canil CM, Delluc A, Reaume N, Carrier M. The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus. J Thromb Haemost 2014; 12: 855-9.Summary. Background: The clinical importance of tumor thrombus in patients with renal cell carcinoma is unknown. We sought to determine the long-term risk of venous thromboembolism (VTE) in patients with residual tumor thrombus postextraction, and to evaluate the impact of residual tumor thrombus on overall survival. Patients/methods: A cohort study of patients with stage III-IV renal cell carcinoma undergoing nephrectomy was undertaken. The primary endpoint was the risk of VTE during a 2-year follow-up period. The secondary endpoint was 2-year overall survival. Results: A total of 170 surgical renal cell carcinoma patients were included, 97 (57.1%) of whom had tumor thrombus. Patients with residual tumor thrombus following surgery had a higher risk of developing VTE than those with complete tumor thrombus resection (hazard ratio [HR] 8.7, 95% confidence interval [CI] 1.7-43.4) and no tumor thrombus (HR 6.5,. Patient with residual tumor thrombus did not have worse overall survival than those with tumor thrombus completely resected or those without tumor thrombus. Conclusions: The presence of residual tumor thrombus is an important risk factor for VTE among renal cell carcinoma patients.

Resection of retroperitoneal sarcoma en‐bloc with inferior vena cava: 20 year outcomes of a single institution

“…This is likely influenced by advances in technology increasing the availability and thrombus following resection of renal cell carcinoma has previously been associated with an increased risk of postoperative VTE, but has not been described in RPS. 27 Unrecognized residual tumor thrombus could feasibly play a similar role in our findings. Despite these events, no patients died or developed significant long-term morbidity as a result of VTE in our study.…”

“…While patients who suffered from VTE had similar demographics and clinicopathologic features as patients without VTE, an intraoperative tumor thrombus was associated with increased risk of postoperative VTE ( P = 0.019). Residual tumor thrombus following resection of renal cell carcinoma has previously been associated with an increased risk of postoperative VTE, but has not been described in RPS . Unrecognized residual tumor thrombus could feasibly play a similar role in our findings.…”

Case report. Perioperatieve anticoagulantia voor de behandeling van een vena cava inferior tumor trombus bij patiënten met niercelcarcinoom

“…deze groep hebben patiënten met een residu-TT een significant verhoogd risico op een VTE tot twee jaar na de operatie (HR 8,7; 95 %-BI = 1,7-43,4) [20]. Het lijkt dus het beste om de postoperatieve behandeling met LMWH per patiënt te bepalen, waarbij geadviseerd kan worden om patiënten na een irradicale resectie van de TT langer met een LMWH te behandelen.…”

Venous thromboembolism prophylaxis in cancer patients — guidelines focus on surgical patients

“…Pettus et al evaluated the VTE incidence in 2208 patients after partial or radical nephrectomy (only mechanical methods of VTE prophylaxis were used) and estimated that symptomatic VTE occurred in 1.5% of patients and pulmonary embolism in 0.9% [209]. In case of renal cancer, risk factors for VTE complications, aside from staging and the presence of metastases, include: the presence of concomitant diseases, long surgery duration, non-radical operation, cancer infiltration into the renal vein and/or inferior caval vein [210][211][212].…”