Surgical Treatment for Renal Cancer Patients With Venous Tumor Thrombus

A study led by Drs. Baohua Zhu, Yiren Yang, and Zhao Huangfu, and published in Translational Andrology and Urology, sought to identify the benefits of surgery and determine prognostic factors for patients with nonmetastatic renal cancer and venous tumor thrombus (VTT).

Researchers retrospectively analyzed the data of 114 patients with nonmetastatic renal cancer and VTT who received surgery between January 2011 and September 2022.

The investigators determined independent risk factors of prognosis using survival analysis based on univariate and multivariate Cox regression models and the Kaplan-Meier method.

Overall survival (OS), the study’s primary end point, was determined using the time from surgery to death or last follow-up.

Of the 114 patients included in the study, 85 were male and 29 were female. Investigators reported 48, 12, 25, 23, and 6 instances of grade 0 to 4 VTT, respectively. Patients in the group dead had higher values in proportion to open surgery, length of stay, preoperative neutrophil, and tumor diameter.

For OS, the 3-year rate was 67.0% and the 5-year rate was 43.8%. The researchers observed no perioperative deaths. At the time of last follow-up, 64 patients had died.

Using multivariate Cox regression analysis, researchers found that independent risk factors included kidney tumor diameter, preoperative lactate dehydrogenase, and preoperative neutrophils. Prognosis was predicated using a nomogram based on independent risk factors and Mayo VTT grading.

The 1-, 2-, 3-, and 5-year OS under the receiver operating characteristic curve of the surveyed patients was 0.82, 0.67, 0.57, and 0.55, respectively.

“In a word, surgical intervention improves the prognosis of renal cancer patients with VTT,” the researchers wrote. “The nomogram enhances the Mayo grading system and serves as a dependable tool for prognostic evaluation in renal cancer patients with VTT.”