Survival Predictors in Patients with Renal Cell Carcinoma and Inferior Vena Cava Tumor Thrombus

By GU Oncology Now Editors - December 1, 2021

Identifying the need for careful selection to outweigh the significant morbidity of surgery for patients with renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus, researchers investigated risk factors and overall survival (OS) and observed that they were able to predict survival duration of patients via risk scoring stratification. The report was presented by the lead author, Alberto C. Pieretti, at the Society of Urologic Oncology’s 22nd Annual Meeting.

“In patients with a [risk] score ≥2, new strategies with preoperative systemic therapy could be considered to improve survival,” Pieretti speculated. The authors also reported a significant association between cT3c, cN1, and cM1 factors and risk of death.

The study retrospectively enrolled 221 patients with RCC with IVC tumor thrombus (pT3b, pT3c) who underwent radical nephrectomy with tumor thrombectomy. Researchers used the Kaplan-Meier method to calculate median OS and employed Cox hazards models to evaluate the association between patients’ risk factors and OS. A risk score was obtained by rounding each result to the nearest integer and using the group with lower mortality risk as the reference.

Patients were divided into three groups depending on the number of risk factors present at their diagnosis. Group one (patients with zero risk factors) had a median OS of 77.6 months (95% confidence interval [CI] 50.5–90.4), group two (patients with one risk factor) had a median OS of 26.0 months (95% CI 19.5–35.2) and group three (patients with two or more risk factors) had a median OS of 8.9 months (95% CI 5.2–12.9; P <0.001).