COMPARATIVE STUDY
JOURNAL ARTICLE

Impact of surgery on the prognosis of metastatic renal cell carcinoma with IVC thrombus received TKI therapy

Taekmin Kwon, Jae-Lyun Lee, Dalsan You, In Gab Jeong, Cheryn Song, Hanjong Ahn, Choung-Soo Kim, Jun Hyuk Hong
Journal of Surgical Oncology 2014, 110 (2): 145-50
24706355

BACKGROUND AND OBJECTIVES: To evaluate the impact of surgery on the prognosis of metastatic renal cell carcinoma (mRCC) with inferior vena cava (IVC) thrombus.

METHODS: In this retrospective study, the medical records of 45 patients who presented with synchronous mRCC with IVC thrombus, between 2005 and 2012, were reviewed. Twenty-eight patients underwent radical nephrectomy with IVC thrombectomy followed by targeted therapy (group 1) and 17 received targeted therapy alone (group 2). Cox proportional hazards regression models served to estimate the prognostic significance of variables.

RESULTS: The median progression-free survival of group 1 and group 2 was 4.1 and 3.5 months, respectively (P = 0.672). Their median overall survival was 17.3 and 19.7 months, respectively (P = 0.353). Multivariate analysis revealed that non-clear cell type RCC (HR = 3.46, P = 0.007) and lymph node metastasis (HR = 2.31, P = 0.003) independently predicted progression-free survival, and Karnofsky performance status (HR = 3.82, P = 0.013) and non-clear cell type RCC (HR = 4.01, P = 0.003) independently predicted overall survival. Surgical resection of the primary renal mass with IVC thrombus did not affect the probability of progression or overall mortality.

CONCLUSIONS: Our limited data set would suggest a limited role for surgery in this patient population and that a prospective study in this group may define the role of surgery.

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