VTE Risk May Hurt Survival After Kidney Cancer Surgery

All-cause mortality was significantly higher among renal cell carcinoma (RCC) patients who developed symptomatic venous thromboembolism (VTE) after undergoing nephrectomy and inferior vena cava (IVC) tumor thrombectomy (TT) accompanied by intravascular tumor thrombosis, a retrospective analysis showed.08/20/2018
Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news

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Abstract INTRODUCTION: Surgical benefits for renal cell carcinoma must be weighed against competing causes of mortality, especially in the elderly patient population. We used a large cancer registry to evaluate the impact of patient and cancer-specific factors on 90-day mortality (90DM). A nomogram to predict the odds of short-term mortality was created. MATERIALS AND METHODS: The National Cancer Database was queried to identify all patients with clinically localized, nonmetastatic disease treated with partial or radical nephrectomy. Using a random sample of 60%, multiple logistic regression with 90DM outcome...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Abstract INTRODUCTION: To develop a risk-stratification model for cancer-specific survival (CSS) following cytoreductive nephrectomy (CN) in the contemporary era. MATERIALS AND METHODS: A retrospective review was performed of 313 patients who underwent CN for M1 renal cell carcinoma (RCC) from 1990 to 2010. To account for the introduction of targeted therapies, timing of surgery was classified as immunotherapy era (1990-2004) or contemporary era (2005-2010). Risk scores were developed to predict CSS using Cox proportional hazards regression models. RESULTS: A total of 215 (69%) and 98 (31%) patients were...
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Renal cell carcinoma (RCC) represents 2-3% of all cancers in adults worldwide, and has an annual increase of around 2% in incidence during the past two decades [1]. Improved diagnostics have resulted in the increasing discovery of low stage renal tumors. Involvement of the venous system is a clinical characteristic of advanced RCC, which is observed in 4-10% of all RCC patients [2]. Radical nephrectomy with thrombectomy (RNTE) is the only curative therapeutic modality for these patients [3]. However, despite the aggressive resection was performed, the long-term survival of RCC with tumor thrombus (TT) remains poor compared to localized RCC.
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Systematic or Meta-analysis Studies Source Type: research
The aim of this study was to investigate the clinical benefit of presurgical therapy with pazopanib in renal cell carcinoma (RCC) patients with a tumor thrombus extending to a high level in the vena cava. A retrospective review was performed for seven consecutive patients with RCC and tumor thrombus involving the vena cava above the hepatic vein (level 3–4, Mayo Clinic classification) treated with pazopanib without initial cytoreductive nephrectomy at our institution. The effect of pazopanib was assessed in terms of the primary site response, thrombus diameter, and height (before and after treatment) on computed tomo...
Source: Anti-Cancer Drugs - Category: Cancer & Oncology Tags: Clinical Reports Source Type: research
Patients with metastatic renal cell carcinoma (mRCC) commonly present with tumor thrombi in the renal vein and inferior vena cava (IVC). The use of cytoreductive nephrectomy (CN) in this population is controversial and the effect on overall survival (OS) is unknown.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Kidney Cancer: Epidemiology & Evaluation/Staging I Source Type: research
The neutrophil-lymphocyte ratio (NLR) is an established signature of inflammation. The limits of this marker for advanced pathology are infrequently examined. We evaluated the utility of NLR in patients undergoing cytoreductive nephrectomy (CN) for metastatic renal cell carcinoma with venous tumor thrombus (mRCCtt).
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Kidney Cancer: Advanced (including Drug Therapy) II Source Type: research
A randomized phase II trial of interleukin-2 and interferon-α plus bevacizumab versus interleukin-2 and interferon-α in metastatic renal-cell carcinoma (mRCC): results from the Danish Renal Cancer Group (DaRenCa) study-1. Acta Oncol. 2018 Feb 02;:1-6 Authors: Donskov F, Jensen NV, Smidt-Hansen T, Brøndum L, Geertsen P Abstract BACKGROUND: Interleukin-2 (IL2)-based immunotherapy is curative for a small subset of patients with metastatic renal-cell carcinoma (mRCC). Preclinical data suggests that bevacizumab (BEV), a humanized anti-VEGF monoclonal antibody, has potential immunomodulat...
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
CONCLUSIONS: The number of positive nodes harvested during LND and LN density was strong prognostic indicators of CSS, while number of removed LNs did not have a significant effect on CSS. The rate of pN1 patients among clinically node-negative patients was relatively high, and LND in these patients suggested a survival benefit. However, only a randomized trial can determine the absolute benefit of LND in this setting. PMID: 29129353 [PubMed - as supplied by publisher]
Source: Urologic Oncology - Category: Urology & Nephrology Authors: Tags: Urol Oncol Source Type: research
Conclusions RN with CT using ECC and DHCA is a challenging procedure which requires a dedicated multidisciplinary working team to minimise complications and maximise patients’ outcomes. Patient summary Patients with kidney cancer and a thrombus within the inferior vena cava, which reaches above the diaphragm, can be treated with surgery. However, this kind of surgical treatment is challenging and requires a dedicated multidisciplinary team in order to accomplish the task. Radical nephrectomy and caval thrombectomy using extracorporeal circulation and deep hypothermic circulatory arrest is a challenging procedure, whi...
Source: European Urology - Category: Urology & Nephrology Source Type: research
Conclusion The pathologic Fuhrman grade, sarcomatoid type, positive surgical margins, and capsular invasion were significant predictors of oncological outcomes in patients with advanced RCC and IVC thrombus.
Source: Urological Science - Category: Urology & Nephrology Source Type: research
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