title: Does a venous tumor thrombus exclude renal transitional cell carcinoma? Implications for neo-adjuvant treatment strategies.
abstract: BACKGROUND
  A venous tumor thrombus (VTT) is well-known in renal cell carcinoma, but we experienced a series of five patients with VTT due to renal transitional cell carcinoma (TCC). Our study aimed to determine the incidence and clinical relevance of this entity.
  
  
  METHODS
  From our prospectively-maintained tumor database, we identified 102 patients with renal TCC according to postoperative histology and analyzed the incidence of VTT in renal TCC from 1990 to 2010.
  
  
  RESULTS
  Five out of 102 patients with TCC (5%) had a VTT. None of these five patients experienced gross haematuria and we presumed correct diagnosis preoperatively in one out of five patients. Univariate analysis revealed that TNM stage and resection status were inferior in the VTT group. All five patients from the VTT group died from their disease, with a median survival of 8.9 months. With regard to all diagnosed VTT, the effective incidence of vena cava involvement in RCC was 48-fold higher than in renal TCC.
  
  
  CONCLUSIONS
  A VTT is very suggestive of renal cell carcinoma. However, before neo-adjuvant treatment, the diagnosis should be assured whenever there is doubt.
authors: Department of Urology, Medical Faculty Carl Gustav Carus, TU of Dresden, Fetscherstr. 74, D-01307 Dresden, Germany. johannes.huber@uniklinikum-dresden.de.
authors: Johannes
authors: J
authors: Huber
authors: Dogu
authors: D
authors: Teber
authors: Gencay
authors: G
authors: Hatiboglu
authors: Valentin
authors: V
authors: Popeneciu
authors: Hildegard
authors: H
authors: Jakobi
authors: Peter
authors: P
authors: Hallscheidt
authors: Sascha
authors: S
authors: Pahernik
authors: Markus
authors: M
authors: Hohenfellner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002295:Carcinoma, Transitional Cell / Q000097:blood* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000097:blood* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D020246:Venous Thrombosis / Q000473:pathology*
keywords: Kidney; neo-adjuvant treatment; renal cell carcinoma; transitional cell carcinoma; venous tumour thrombus