Venous Tumor Thrombus Across Malignancies: Imaging, Management, and Clinical Implications
7 affiliations
- 1Musculoskeletal Tumor Center, Beijing Key Laboratory for Musculoskeletal Tumors, Peking University People’s Hospital, Beijing 100044, China
- 2Department of Vascular Surgery, Peking University People’s Hospital, Beijing 100044, China
- 3Department of Hepatobiliary Surgery, Peking University People’s Hospital, Beijing 100044, China
- 4Department of Urology, Peking University People’s Hospital, Beijing 100044, China
- 5Department of Orthopedics, Peking University First Hospital, Beijing, 100034, China
- 6Department of Pathology, Peking University Shougang Hospital, Beijing, 100144, China
- 7Department of Pathology, Peking University People’s Hospital, Beijing 100044, China
Abstract
Venous tumor thrombus (VTT) is a clinically important manifestation of malignancy that creates diagnostic, therapeutic, and prognostic challenges. Evidence is highly uneven across tumor types: renal cell carcinoma and hepatocellular carcinoma account for much of the available clinical experience, whereas data for rarer tumors, including sarcomas, remain limited. This narrative review was based on a structured PubMed search supplemented by relevant publications identified through reference checking and subsequent topic-specific reading. We review the incidence, imaging evaluation, surgical and non-surgical management, and prognosis of VTT across major malignancies. Although several considerations are shared across tumor types, including assessment of thrombus extent, venous wall involvement, venous patency, collateral circulation, resectability, and systemic disease status, their clinical implications differ according to the underlying malignancy. In particular, treatment strategies established in well-studied tumors should not be directly extrapolated to rarer malignancies with different tumor biology, treatment sensitivity, and patterns of disease progression. A cross-tumor approach may therefore be most useful for defining common questions in VTT assessment and multidisciplinary planning, while treatment decisions remain tumor-specific. Future progress will require standardized reporting, multicenter collaboration, and better integration of emerging systemic therapies into multidisciplinary care.
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BibTeX
@article{liang2026venous,
title = {{Venous Tumor Thrombus Across Malignancies: Imaging, Management, and Clinical Implications}},
author = {Haijie Liang and Jingjun Jiang and Songyi Guo and Xu Tang and Xingyu Liu and Feiyang Qi and Guyue Bian and Kuisheng Liu and Siyi Huang and Boyang Wang and Shidong Wang and Jun Wang and Taiqiang Yan and Yunfan Wang and Kunkun Sun and Wei Guo and Jichuan Wang and Yi Yang},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213422},
url = {https://www.mdpi.com/2072-6694/18/21/3422},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Venous Tumor Thrombus Across Malignancies: Imaging, Management, and Clinical Implications
AU - Haijie Liang
AU - Jingjun Jiang
AU - Songyi Guo
AU - Xu Tang
AU - Xingyu Liu
AU - Feiyang Qi
AU - Guyue Bian
AU - Kuisheng Liu
AU - Siyi Huang
AU - Boyang Wang
AU - Shidong Wang
AU - Jun Wang
AU - Taiqiang Yan
AU - Yunfan Wang
AU - Kunkun Sun
AU - Wei Guo
AU - Jichuan Wang
AU - Yi Yang
PY - 2026
DA - 2026/10/22
JO - Cancers
DO - 10.3390/cancers18213422
UR - https://www.mdpi.com/2072-6694/18/21/3422
AB - Venous tumor thrombus (VTT) is a clinically important manifestation of malignancy that creates diagnostic, therapeutic, and prognostic challenges. Evidence is highly uneven across tumor types: renal cell carcinoma and hepatocellular carcinoma account for much of the available clinical experience, whereas data for rarer tumors, including sarcomas, remain limited. This narrative review was based on a structured PubMed search supplemented by relevant publications identified through reference checking and subsequent topic-specific reading. We review the incidence, imaging evaluation, surgical and non-surgical management, and prognosis of VTT across major malignancies. Although several considerations are shared across tumor types, including assessment of thrombus extent, venous wall involvement, venous patency, collateral circulation, resectability, and systemic disease status, their clinical implications differ according to the underlying malignancy. In particular, treatment strategies established in well-studied tumors should not be directly extrapolated to rarer malignancies with different tumor biology, treatment sensitivity, and patterns of disease progression. A cross-tumor approach may therefore be most useful for defining common questions in VTT assessment and multidisciplinary planning, while treatment decisions remain tumor-specific. Future progress will require standardized reporting, multicenter collaboration, and better integration of emerging systemic therapies into multidisciplinary care.
SN - 2072-6694
ER -