title: Limited benefit of targeted molecular therapy for inferior vena cava thrombus associated with renal cell carcinoma.
abstract: BACKGROUND
  The clinical benefit of targeted molecular therapy (TMT) for an inferior vena cava (IVC) tumor thrombus associated with renal cell carcinoma (RCC) is unclear. The aim of the present study was to assess the change in IVC thrombus height during TMT and to identify the factors associated with the effect of TMT on an IVC thrombus in RCC patients.
  
  
  METHODS
  The present study retrospectively analyzed 21 patients with an IVC thrombus who were treated with TMT at our hospital. Thrombus height and level before and after TMT were assessed using CT or MRI. Furthermore, we examined the factors associated with the effect of TMT on the IVC thrombus.
  
  
  RESULTS
  The tumor thrombus level before TMT was I in 2 patients (10%), II in 10 (47%), III in 4 (19%), and IV in 5 (24%). Following TMT, the tumor thrombus height decreased in 16 patients (76%), and the mean decrease was 17 mm. The tumor thrombus height increased in 5 patients (24%), and the mean increase was 30 mm. The tumor thrombus level decreased in 4 patients (19%), remained stable in 15 patients (71%), and increased in 2 patients (10%). We found that the clinical nodal stage (p = 0.025) was significantly associated with and the serum neutrophil count (p = 0.067) tended to be associated with the reduction in the IVC thrombus.
  
  
  CONCLUSIONS
  The clinical benefit of TMT for an IVC thrombus associated with RCC is limited.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan. tkondo@kc.twmu.ac.jp.
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan.
authors.forename: Jumpei
authors.initials: J
authors.lastname: Iizuka
authors.affiliation: Department of Surgical Pathology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nagashima
authors.affiliation: Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-Ku, Tokyo, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D012189:Retrospective Studies; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000187:drug effects / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: Renal cell carcinoma; Targeted molecular therapy; Tumor thrombus