The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus.
BACKGROUND
The clinical importance of tumor thrombus in patients with renal cell carcinoma is unknown. We sought to determine the long-term risk of venous thromboembolism (VTE) in patients with residual tumor thrombus postextraction, and to evaluate the impact of residual tumor thrombus on overall survival.


METHODS
A cohort study of patients with stage III-IV renal cell carcinoma undergoing nephrectomy was undertaken. The primary endpoint was the risk of VTE during a 2-year follow-up period. The secondary endpoint was 2-year overall survival.


RESULTS
A total of 170 surgical renal cell carcinoma patients were included, 97 (57.1%) of whom had tumor thrombus. Patients with residual tumor thrombus following surgery had a higher risk of developing VTE than those with complete tumor thrombus resection (hazard ratio [HR] 8.7, 95% confidence interval [CI] 1.7-43.4) and no tumor thrombus (HR 6.5, 95% CI 1.7-24.7). Patient with residual tumor thrombus did not have worse overall survival than those with tumor thrombus completely resected or those without tumor thrombus.


CONCLUSIONS
The presence of residual tumor thrombus is an important risk factor for VTE among renal cell carcinoma patients.
Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
R
R
Ihaddadene
D W
DW
Yokom
G
G
Le Gal
P
P
Moretto
C M
CM
Canil
A
A
Delluc
N
N
Reaume
M
M
Carrier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006503:Hepatic Veins / Q000473:pathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D009392:Nephrectomy / Q000009:adverse effects / Q000401:mortality; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D012082:Renal Veins / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D020246:Venous Thrombosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
neoplasm; nephrectomy; renal cell carcinoma; venous thromboembolism; venous thrombosis