title: Renal cell carcinoma with vascular invasion: Mortality and prognostic factors.
abstract: OBJECTIVE
  Analysis of the results of patients who had been operated of renal cell carcinoma with vascular invasion in our institution, evaluation of prognostic factors and complications.
  
  
  METHODS
  Retrospective observational study of 37 patients diagnosed of renal cell carcinoma with vascular invasion operated between May 1999 and July 2013. We used the method of Kaplan-Meier survival analysis and the Mantel-Haenszel's test (log rank) and the Cox's proportional hazards analysis test to analyse the risk factors of mortality.
  
  
  RESULTS
  The median age was 60 years. Mean follow-up period was 42.1 months. The median overall survival and disease-free survival were 53.8and 36.3 months, respectively. There was statistical association between overall survival and ASA (p=0.047), tumor stage (p=0.003), lymph node involvement (p=0.024), presence of metastases (p=0.013), level of tumor thrombus (p=0, 05) and histological type (p=0.001). 14 patients had grade IIIb complications or higher according to the Clavien Dindo classification, the most frequent was bleeding.
  
  
  CONCLUSIONS
  Renal cell carcinoma with vascular invasion is a disease with high rate of mortality. Surgery is a therapeutic option that can be curative. The number of complications is important. Survival is conditioned by the ASA, tumor stage, the level of tumor thrombus, lymph node involvement, metastasis and histological type.
authors.affiliation: Servicios de Urología, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: mrcabello.uro@gmail.com.
authors.forename: M A
authors.initials: MA
authors.lastname: Rodríguez-Cabello
authors.affiliation: Servicios de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Laso-García
authors.affiliation: Servicios de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Donis-Canet
authors.affiliation: Servicios de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: V
authors.initials: V
authors.lastname: Gómez-Dos-Santos
authors.affiliation: Servicios de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Varona-Crespo
authors.affiliation: Servicios de Urología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Burgos-Revilla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D019043:Vascular Neoplasms / Q000473:pathology*; D055815:Young Adult
keywords: Carcinoma de células renales; Factores pronósticos; Invasión vascular; Prognostic factors; Renal cell carcinoma; Supervivencia; Survival; Trombo tumoral; Tumour thrombus; Vascular invasion