Key result
Tumor size did not significantly influence the progression of venous tumor thrombus into the inferior vena cava, with patients demonstrating an overall mean survival time of 66.4 months.
Why the study?
To describe perioperative outcomes, disease-specific survival, and overall survival status in patients diagnosed with renal cell carcinoma with inferior vena cava tumor thrombus.
Observational (n=39)
No
In patients with RCC and IVC tumor thrombus, tumor size does not influence the level of thrombus progression, and aggressive surgical resection yields acceptable survival despite high complication rates.
May not warrant tumor size-based thrombus risk adjustments; leaves open prospective validation of prognostic factors.
Objective: The objective of the study is to describe the perioperative outcomes, disease-specific, and overall survival status in patients diagnosed with renal cell carcinoma with inferior vena cava (IVC) tumor thrombus. Patients and Methods: We did a retrospective analysis of all patients who underwent radical nephrectomy along with IVC thrombectomy from the year 2013 to 2020. Mayo’s classification was used to stratify the level of IVC thrombus. Demographic, perioperative, histopathology data, complications, and survival status were analyzed. Results: Total number of patients included in the study was 39, (Male: Female = 84.6%: 15.4%). Median age of patients was 58 (interquartile range [IQR] 50–63) years. Median size of renal tumor (in cms) was 9.5 (IQR 7.5–12), 8 (IQR 7–11.5), 8.5 (IQR 7–11.75), and 11 (IQR 9.5–11) ( P = 0.998) in level 1,2,3, and 4 tumors, respectively. Clear cell variant was seen in 32 patients (82%) with R0 resection in 17 patients. Twelve patients (30.7%) had systemic metastasis on presentation. The overall mean survival time was 66.4 months with 95% confidence interval (CI) (52.4–80.5 months). Mean recurrence-free survival is 76 months with (63–90) CI of 95%. Mean survival in patients who presented with metastasis is 47 months with 95% CI (52.4–80.5). Perioperative mortality rate was 5.12% in this study. Conclusion: The tumor size does not have an influence on the progression of tumor thrombus into IVC. Significant difference in survival was observed between different levels of thrombus with high mortality in level four tumors.
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Thangarasu et al. (2022) conducted an observational in Renal cell carcinoma with inferior vena cava (IVC) tumor thrombus (n=39). Tumor size and IVC thrombus level was evaluated on Overall survival (Mean 66.4 months, 95% CI 52.4-80.5). Tumor size did not significantly influence the progression of venous tumor thrombus into the inferior vena cava, with patients demonstrating an overall mean survival time of 66.4 months.
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