Clinical Outcomes of Radical Surgery in Patients with Renal Carcinoma
and Associated Venous Thrombosis: Single-Center Experience in a Tertiary
Care Institution
Abstract
Background: Renal carcinoma and associated venous thrombosis
cause-specific perioperative and postoperative challenges. We aimed to
evaluate the factors affecting clinical outcomes in patients undergoing
radical surgery due to renal carcinoma and associated venous thrombosis.
Materials and methods: Hospital records were retrospectively reviewed to
identify patients with renal carcinoma and associated venous thrombosis
treated with radical surgery between 2006 and 2019. Preoperative,
perioperative, and postoperative findings were analyzed to determine the
associations between clinical and survival outcomes. Overall and
disease-free survival was analyzed by the Kaplan-Meier method. Other
associated prognostic variables were assessed using univariate and
multivariate Cox regression analyses. Results: Thirty-three patients
with renal carcinoma and associated venous thrombosis were enrolled for
this study. There were 15 (45.4%) patients with level I, five (15.2%)
with level II, eight (24.2%) with level III, and five (15.2%) with
level IV venous thrombosis according to the Mayo Clinic classification
system. The median follow-up was 35.6 months. In the univariate
analysis, increased tumor size was associated with poor overall and
disease-free survival. Preoperative clinic M1 disease was associated
with poor overall survival. A high Mayo Clinic thrombus level was
associated with poor disease-free survival. In the multivariate
analysis, only tumor size and clinic M1 disease were independently
correlated with poor overall survival. No independent statistically
significant association was detected between thrombus level and survival
outcomes. Conclusions: Although the thrombus level was not associated
with overall and disease-free survival, tumor size and clinic M1 disease
were found to have an independent prognostic impact on overall survival.