Abstract
Background and Objectives: This study evaluates the prognostic value of venous tumor thrombus (VTT) in patients with advanced renal cell carcinoma (RCC) undergoing radical resection and inferior vena cava (IVC) thrombectomy. Methods: Retrospective review of patients with radical nephrectomy for RCC and associated VTT (2000−2024). Patients were dichotomized into Neves 0−II (infrahepatic) and Neves III−IV groups (suprahepatic) IVC involvement for univariate analysis. Results: A total of 64 patients (34 Neves 0−II and 30 Neves III−IV) were analyzed. No significant differences in patient or cancer characteristics. Neves III−IV was associated with greater blood loss (> 2 L) (62.1% vs. 37.9%, p = 0.02), greater intensive care unit length of stay (LOS) (4.4 vs. 1.4 days, p = 0.02), and postoperative LOS (11.0 vs. 6.5 days, p = 0.005). Overall, 30-day mortality was only 1.6% with a mean follow-up of 56.1 months. Local recurrence was 7.8% and IVC patency 96.9%. One-year survival was 82.0%, 5-year survival was 58.4%, and 15-year survival was 42.5% without significant difference between Neves levels. Conclusions: Radical nephrectomy with VTT thrombectomy and primary IVC repair is safe with high early survival and low local recurrence. Extent of IVC tumor thrombus extension is not a poor prognostic factor for early or late survival.
Original language | English (US) |
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Journal | Journal of surgical oncology |
DOIs | |
State | Accepted/In press - 2024 |
Funding
The authors have nothing to report. This work was supported by the NHLBI Ruth L. Kirschstein National Research Service Award 5T32HL094293\u201014.
Keywords
- inferior vena cava
- Neves classification
- renal cell carcinoma
- venous reconstruction
- venous tumor thrombus
ASJC Scopus subject areas
- Surgery
- Oncology