Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus

Jared M Whitson, Adam C. Reese, Maxwell V. Meng

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Objectives: To identify prognostic factors for renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and determine the significance of thrombus level on survival. Materials and methods: Patients within the Surveillance, Epidemiology, and End Results (SEER) database with RCC and VTT were identified and included if managed surgically. The Kaplan-Meier method and Cox regression analyses were performed to identify factors associated with disease-specific survival. Results: A total of 1,875 patients met the inclusion criteria. One-year survival for patients undergoing surgery was 60% for patients with metastases and 90% for those without. Factors associated with worse survival included larger tumor size (HR 1.2, 95% CI 1.0-1.4), medullary, collecting duct, or sarcomatoid histology (HR 2.2, 95% CI 1.5-3.3), Fuhrman grade 3 (HR 2.2, 95% CI 1.5-3.3) or grade 4 (HR 2.9, 95% CI 1.8-4.5) tumors, positive lymph nodes (HR 1.5, 95% CI 1.0-2.0), and metastases (HR 3.5, 95% CI 2.6-4.8). Thrombus level above the diaphragm (T3c) was not significantly associated with worse survival (HR 1.4, 95% CI 0.8-2.5). Conclusions: In this large, population-based study of patients with RCC and VTT, we identify several disease-specific factors strongly associated with cancer-specific mortality. After controlling for adverse prognostic factors, thrombus level was not associated with worse outcome.

Original languageEnglish (US)
Pages (from-to)259-263
Number of pages5
JournalUrologic Oncology: Seminars and Original Investigations
Volume31
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Keywords

  • Carcinoma
  • Inferior
  • Nephrectomy
  • Renal cell
  • Survival
  • Vena cava

ASJC Scopus subject areas

  • Oncology
  • Urology

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