Reassessing prognosis in renal cell carcinoma with venous tumor thrombus: Prospective data from 46 cases.
- 1Department of Uro-Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
- 2Department of Pathology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India.
- 3Department of Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Abstract
Objectives
To evaluate perioperative and oncologic outcomes after radical nephrectomy with inferior vena cava (IVC) thrombectomy for renal cell carcinoma (RCC) with venous tumor thrombus, and to assess whether survival relates more to thrombus extent or tumor biology.Materials and methods
This prospective cohort study enrolled 46 patients with RCC and IVC tumor thrombus treated between 2019 and 2022; the last follow-up was March 2025. The primary endpoints were overall survival (OS) and cancer-specific survival (CSS), estimated using Kaplan-Meier analysis and exploratory univariate Cox regression.Results
Median age was 59.5 years; 36 of 46 were male. Thrombus level was Mayo I in 17, II in 20, III in 7, and IV in 2; 8 had pM1, and 7 had pN1 disease. Median follow-up was 24 months; 26 patients were alive, 18 had died, and 2 were lost to follow-up. 1- and 3-year OS were 78% and 50% (extrapolated); 3-year CSS was approximately 60%. Median OS was 36 months in non-metastatic (n = 38) versus 10 months in metastatic patients (n = 8) (P < 0.001). Nodal involvement (Hazard Ratio [HR] 2.8, P = 0.03) and metastasis (HR 5.1, P = 0.001) predicted poor survival; thrombus level was not associated with OS or CSS (P = 0.65). R0 resection was achieved in 44 of 46 patients. Complications occurred in 7 patients (1 major), with 2 perioperative deaths.Conclusion
In this small prospective cohort, metastatic and nodal status, rather than thrombus extent, were associated with survival, though limited sample size precludes definitive conclusions. Thrombus level affected surgical complexity but not OS or CSS.
Related
- Renal cell carcinoma with venous tumor thrombus in young adults: Distinct clinicopathological features and shorter progression-free survival.
- Intracardiac thrombus and multiple venous thromboses revealing focal segmental glomerulosclerosis
- Intravascular Ultrasound-Guided Iliofemoral Venous Stenting: In-Stent Mural Thrombus as a Possible Early Sign of Occult Malignancy
- Venous Tumor Thrombus Across Malignancies: Imaging, Management, and Clinical Implications
- Response to comments on “Robotic surgical techniques and methods for treating renal cell carcinoma with inferior vena cava tumor thrombus”
BibTeX
@article{meyyappan2026reassessing,
title = {{Reassessing prognosis in renal cell carcinoma with venous tumor thrombus: Prospective data from 46 cases.}},
author = {Vivek Meyyappan and Rakesh Manilal Sharma and Amaresh Mohan and L Janaki Kavasseri and Praveen Balagangatharan and S Lohith and Neelanolla Bhasker Reddy and Manoj Kharade and B Vishal Rao and Bhavyadeep Korrapati},
journal = {Indian journal of urology : IJU : journal of the Urological Society of India},
year = {2026},
month = sep,
doi = {10.4103/iju.iju_121_26},
url = {https://europepmc.org/article/MED/42910394},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Reassessing prognosis in renal cell carcinoma with venous tumor thrombus: Prospective data from 46 cases.
AU - Vivek Meyyappan
AU - Rakesh Manilal Sharma
AU - Amaresh Mohan
AU - L Janaki Kavasseri
AU - Praveen Balagangatharan
AU - S Lohith
AU - Neelanolla Bhasker Reddy
AU - Manoj Kharade
AU - B Vishal Rao
AU - Bhavyadeep Korrapati
PY - 2026
DA - 2026/09/29
JO - Indian journal of urology : IJU : journal of the Urological Society of India
DO - 10.4103/iju.iju_121_26
UR - https://europepmc.org/article/MED/42910394
AB - Objectives To evaluate perioperative and oncologic outcomes after radical nephrectomy with inferior vena cava (IVC) thrombectomy for renal cell carcinoma (RCC) with venous tumor thrombus, and to assess whether survival relates more to thrombus extent or tumor biology.Materials and methods This prospective cohort study enrolled 46 patients with RCC and IVC tumor thrombus treated between 2019 and 2022; the last follow-up was March 2025. The primary endpoints were overall survival (OS) and cancer-specific survival (CSS), estimated using Kaplan-Meier analysis and exploratory univariate Cox regression.Results Median age was 59.5 years; 36 of 46 were male. Thrombus level was Mayo I in 17, II in 20, III in 7, and IV in 2; 8 had pM1, and 7 had pN1 disease. Median follow-up was 24 months; 26 patients were alive, 18 had died, and 2 were lost to follow-up. 1- and 3-year OS were 78% and 50% (extrapolated); 3-year CSS was approximately 60%. Median OS was 36 months in non-metastatic (n = 38) versus 10 months in metastatic patients (n = 8) (P < 0.001). Nodal involvement (Hazard Ratio [HR] 2.8, P = 0.03) and metastasis (HR 5.1, P = 0.001) predicted poor survival; thrombus level was not associated with OS or CSS (P = 0.65). R0 resection was achieved in 44 of 46 patients. Complications occurred in 7 patients (1 major), with 2 perioperative deaths.Conclusion In this small prospective cohort, metastatic and nodal status, rather than thrombus extent, were associated with survival, though limited sample size precludes definitive conclusions. Thrombus level affected surgical complexity but not OS or CSS.
SN - 0970-1591
SN - 1998-3824
ER -