Key result
Tumor thrombus in late-stage renal cell carcinoma patients awaiting nephrectomy increased the incidence of preoperative VTE compared to patients without tumor thrombus (5.7% vs 0%; P=0.026).
Why the study?
Does the presence of tumor thrombus increase the risk of preoperative venous thromboembolism in patients with late-stage renal cell carcinoma awaiting nephrectomy?
Cohort (n=176)
No
Does the presence of tumor thrombus increase the risk of preoperative venous thromboembolism in patients with late-stage renal cell carcinoma awaiting nephrectomy?
Absolute Event Rate: 5.7% vs 0%
p-value: p=0.026
The presence of tumor thrombus in late-stage renal cell carcinoma patients awaiting nephrectomy significantly increases the incidence of preoperative venous thromboembolism.
Tumor thrombus was associated with higher preoperative VTE in advanced RCC; leaves open whether targeted prophylaxis warrants prospective evaluation.
BACKGROUND: The clinical impact of a tumor thrombus in renal cell carcinoma (RCC) patients awaiting radical nephrectomy and thrombectomy is unknown. OBJECTIVE: To determine the incidence of venous thromboembolism (VTE) in RCC patients with tumor thrombus prior to nephrectomy. PATIENTS AND METHODS: We conducted a retrospective cohort study including all late-stage (stage 3-4 excluding T1-2 N0M0) RCC patients who underwent radical nephrectomy at our institution between 1 January 2005 and 1 July 2012. Tumor thrombus was defined as the presence of an intraluminal filling defect in the renal vein, hepatic vein, portal vein, or inferior vena cava, directly extending from a renal mass detected on computed tomography. RESULTS: A total of 176 patients were included in the study. Fifty-three (30.1%) patients had tumor thrombus diagnosed on imaging Three patients with tumor thrombus (5.7%; 95% confidence interval [CI] 1.4-16.8) developed a VTE while awaiting radical nephrectomy, whereas none (0%; 95% CI 0-2.9) of the patients without a tumor thrombus had an event (P = 0.026). All three events were deep vein thrombosis. Times from tumor thrombus diagnosis to VTE were 5, 15 and 21 days. CONCLUSIONS: Tumor thrombus on imaging is a frequent finding among RCC patients awaiting nephrectomy. The presence of tumor thrombus in these patients increases the incidence of preoperative VTE.
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Yokom et al. (2013) conducted a cohort in Renal cell carcinoma (n=176). Tumor thrombus vs. No tumor thrombus was evaluated on Venous thromboembolism (VTE) (p=0.026). Tumor thrombus in late-stage renal cell carcinoma patients awaiting nephrectomy increased the incidence of preoperative VTE compared to patients without tumor thrombus (5.7% vs 0%; P=0.026).
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