title: Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival.
abstract: BACKGROUND
  Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort.
  
  
  METHODS
  The records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors.
  
  
  RESULTS
  VTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS.
  
  
  CONCLUSIONS
  In the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764-768. © 2016 Wiley Periodicals, Inc.
authors: Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany. rene.mager@unimedizin-mainz.de.
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authors: USC/Norris Comprehensive Cancer Center, Los Angeles, California.
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authors: Daneshmand
authors: Department of Urology, UC Davis Medical Center, Sacramento, California.
authors: Christopher P
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authors: Evans
authors: Department of Urology, Fundació Puigvert, Barcelona, Spain.
authors: Joan
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authors: Palou
authors: Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain.
authors: Juan I
authors: JI
authors: Martínez-Salamanca
authors: Department of Urology, Emory University, Atlanta, Georgia.
authors: Viraj A
authors: VA
authors: Master
authors: Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York.
authors: James M
authors: JM
authors: McKiernan
authors: Department of Urology, Lahey Clinic, Burlington, Massachusetts.
authors: John A
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authors: Libertino
authors: Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany.
authors: Axel
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authors: Haferkamp
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authors: Axel
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authors: Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain.
authors: Joaquín A
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authors: Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain.
authors: Venancio
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authors: Miami Transplant Institute, University of Miami, Miami, Florida.
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authors: Daneshmand
authors: Department of Urology, UC Davis Medical Center, Sacramento, California.
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authors: Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy.
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authors: Department of Urology, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain.
authors: Javier
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authors: Department of Urology, University of Heidelberg, Heidelberg, Germany.
authors: Markus
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authors: Department of Urology, New York University School of Medicine, New York, New York.
authors: William C
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authors: Department of Urology, Oregon Health and Science University, Portland, Oregon.
authors: Theresa M
authors: TM
authors: Koppie
authors: Department of Urology, Lahey Clinic, Burlington, Massachusetts.
authors: John A
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authors: Libertino
authors: Department of Urology, Hospital Universitario Infanta Sofía, Madrid, Spain.
authors: Estefanía Linares
authors: EL
authors: Espinós
authors: Department of Urology, Emory University, Atlanta, Georgia.
authors: Adam
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authors: Lorentz
authors: Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain.
authors: Juan I
authors: JI
authors: Martínez-Salamanca
authors: Department of Urology, Emory University, Atlanta, Georgia.
authors: Viraj A
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authors: Master
authors: Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York.
authors: James M
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authors: McKiernan
authors: Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy.
authors: Francesco
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authors: Montorsi
authors: Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
authors: Giacomo
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authors: Novara
authors: Department of Urology, Weill Cornell Medical Center, New York, New York.
authors: Padraic
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authors: O'Malley
authors: Department of Urology, University of Heidelberg, Heidelberg, Germany.
authors: Sascha
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authors: Pahernik
authors: Department of Urology, Fundació Puigvert, Barcelona, Spain.
authors: Joan
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authors: Palou
authors: Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors: José Luis Pontones
authors: JL
authors: Moreno
authors: Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina.
authors: Raj S
authors: RS
authors: Pruthi
authors: Department of Urology, Fundació Puigvert, Barcelona, Spain.
authors: Oscar Rodriguez
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authors: Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
authors: Paul
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authors: Russo
authors: Department of Urology, Weill Cornell Medical Center, New York, New York.
authors: Douglas S
authors: DS
authors: Scherr
authors: Department of Urology, Medical University of Vienna, Vienna, Austria.
authors: Shahrokh F
authors: SF
authors: Shariat
authors: Department of Urology, University of Würzburg, Würzburg, Germany.
authors: Martin
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authors: Spahn
authors: Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy.
authors: Carlo
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authors: Terrone
authors: Department of Urology, UC Davis Medical Center, Sacramento, California.
authors: Derya
authors: D
authors: Tilki
authors: Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain.
authors: Dario
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authors: Vázquez-Martul
authors: Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors: Cesar Vera
authors: CV
authors: Donoso
authors: Department of Urology, University of Würzburg, Würzburg, Germany.
authors: Daniel
authors: D
authors: Vergho
authors: Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina.
authors: Eric M
authors: EM
authors: Wallen
authors: Department of Urology, Medical University of Graz, Graz, Austria.
authors: Richard
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authors: Zigeuner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014682:Vena Cava, Inferior / Q000473:pathology*; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology
keywords: cancer specific survival; renal cell carcinoma; thrombus consistency; venous tumor thrombus