Prognostic value of BAP1 expression in clear cell renal cell carcinoma with inferior vena cava tumor thrombosis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16080-e16080
Author(s):  
Suguru Oka ◽  
Naoko Inoshita ◽  
Yuji Miura ◽  
Ryosuke Oki ◽  
Yu Miyama ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Poor Prognosis ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Clear Cell ◽  
Vena Cava ◽  
Ivc Tumor

e16080 Background: Renal cell carcinoma (RCC) is characterized by a propensity for extension into the renal vein and inferior vena cava (IVC), and affected patients have a poor prognosis. BAP1 mutation, which occurs in about 15% of patients with clear cell RCC (ccRCC), also predicts a poor prognosis. The aim of this study was to elucidate the association between BAP1 expression and clinicopathologic outcomes in patients with ccRCC with an IVC tumor thrombus. Methods: Thirty-nine patients with ccRCC with an IVC tumor thrombus who underwent radical nephrectomy and tumor thrombectomy at our institution from 1999 to 2010 were retrospectively evaluated. Immunohistochemical analyses were performed for the expression of BAP1, and the associations between the expression of BAP1 and clinical outcomes were assessed. Survival analyses were performed using the Kaplan–Meier method and log-rank test. Multivariate analyses of the associations between overall survival (OS) and clinical variables were performed using a Cox proportional hazard model. For all analyses, P < 0.05 was considered statistically significant. Results: The median follow-up time was 58.8 months (range, 2–130 months). The median age was 66 years (range, 37–80 years). Four patients (10.3%) had lung metastasis at the initial diagnosis. The primary tumor was right-sided in 27 (69.2%) patients and left-sided in 12 (30.8%). The IVC tumor thrombus extended above and below the diaphragm in 11 (28.2%) and 28 (71.8%) patients, respectively. The KPS score was > 80 in 23 patients (59.0%). BAP1 expression was positive in 26 (67.0%) cases and negative in 13 (33.0%). BAP1-negative tumors were associated with a significantly shorter OS than BAP1-positive tumors (median OS, 42.0 vs. 81.5 months, respectively; P = 0.019). The median disease-free survival in BAP1-negative and -positive tumors was 10.0 and 19.0 months, respectively (P = 0.019). Multivariate analysis showed that only a BAP1-negative status was significantly associated with shorter OS (P = 0.026). Conclusions: A BAP1-negative tumor status was significantly associated with a poor prognosis in patients with ccRCC with an IVC tumor thrombus who underwent radical nephrectomy and tumor thrombectomy.

scholarly journals Sonographic Evaluation of Inferior Vena Cava Tumor Thrombus in Renal Cell Carcinoma: A Case Study of a Rare Condition

2018 ◽  
Vol 34 (5) ◽  
pp. 375-382
Author(s):  
Viyana Hamblen
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Wilms Tumor ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Ivc Tumor

Inferior vena cava (IVC) tumor thrombus in renal cell carcinoma is a rare entity that suggests heightened biologic behavior and a surgical challenge during the course of treatment. Tumor thrombus can extend from the renal vein to the right atrium. This cephalad extension is classified by four different levels. These levels determine which surgical approach is used, whether a thoracoabdominal incision is needed, and whether a patient needs to be placed in circulatory arrest. Complete surgical resection of the tumor is potentially the only curative treatment, although it supposes a challenge because of operative difficulty and the potential for massive bleeding or tumor pulmonary thromboembolism. IVC tumor thrombus presents with a few differentials that need to be assessed, including bland thrombus, primary IVC leiomyosarcoma, hepatocellular carcinoma, adrenal cortical carcinoma, primary lung carcinoma, and Wilms tumor. The importance of diagnosing IVC tumor thrombus secondary to renal cell carcinoma is demonstrated as well as a sonographic protocol for assessing IVC tumor thrombus.

scholarly journals Renal cell carcinoma with inferior vena cava thrombus extending to the right atrium diagnosed during pregnancy

2017 ◽  
Vol 9 (6) ◽  
pp. 155-159 ◽  
Author(s):  
Efe C. Ghanney ◽  
Jaime A. Cavallo ◽  
Matthew A. Levin ◽  
Ramachandra Reddy ◽  
Jeffrey Bander ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Renal Cell ◽  
Lupus Anticoagulant ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Ivc Tumor ◽  
The Right

Only one case of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumor thrombus diagnosed and treated during pregnancy has been reported in the literature. In that report, the tumor thrombus extended to the infrahepatic IVC (level II tumor thrombus). In the present case, a 37-year-old woman with lupus anticoagulant antibodies was diagnosed with RCC and IVC tumor thrombus extending to the right atrium (level IV tumor thrombus) at 24 weeks of pregnancy. The fetus was safely delivered by cesarean section at 30 weeks of gestation. At 4 days later, an open right radical nephrectomy and IVC and right atrial thrombectomy were performed on cardiopulmonary bypass (CPB) once the patient’s hemodynamic status had been optimized. Fetal and maternal concerns included the risk of a thromboembolic event (due to increased hypercoagulability from pregnancy, active malignancy, and lupus anticoagulant), intraoperative hemorrhage risk (due to extensive venous collaterals and anticoagulation), and fetal morbidity and mortality (due to fetal lung immaturity). Standardized guidelines for treatment of RCC with or without IVC tumor thrombus during pregnancy are unavailable due to the infrequency of such cases. Treatment decisions are therefore individualized and this case report may inform the management of future patients diagnosed with RCC with level IV tumor thrombus during pregnancy.

scholarly journals Impact of miR-21, miR-126 and miR-221 as Prognostic Factors of Clear Cell Renal Cell Carcinoma with Tumor Thrombus of the Inferior Vena Cava

PLoS ONE ◽  
2014 ◽  
Vol 9 (10) ◽  
pp. e109877 ◽  
Author(s):  
Daniel Claudius Vergho ◽  
Susanne Kneitz ◽  
Charis Kalogirou ◽  
Maximilian Burger ◽  
Markus Krebs ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Clear Cell ◽  
Vena Cava ◽  
Cell Renal Cell Carcinoma

scholarly journals Survival Benefits After Surgery of Renal Cell Carcinoma Patients with Inferior Vena Cava Thrombus

2021 ◽  
Author(s):  
Tawatchai Taweemonkongsap ◽  
Ekkarin Chotikawanich ◽  
Siros Jitpraphai ◽  
Varat Woranisarakul ◽  
Thitipat Hansomwong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Significant Difference ◽  
Ivc Thrombus

Abstract OBJECTIVE: To evaluate surgical and oncological outcomes after surgery in renal cell carcinoma (RCC) patients with inferior vena cava (IVC) tumor thrombus METHODS: A total of 58 patients from 2002 to 2019 underwent radical nephrectomy and IVC thrombectomy at Siriraj Hospital, Bangkok, Thailand, were retrospectively reviewed. Kaplan-Meier analysis was utilized to compare survival benefits between cohorts and Cox regression to evaluate predictors of patient survival. RESULTS: There were 5 (8.6%), 21 (36.2%), 23 (39.7%) and 9 (15.5%) patients with tumor thrombus level I, II, III and IV respectively. The major complications (Clavien 3-5) were observed in 15 patients (25.8%) and 80% were patients with high thrombus level (III-IV). There was 9% mortality (5 patients): 2 intraoperatively and 3 postoperatively. Median follow-up was 15 months (IQR:5-41). Two-year overall survival (OS) was 80% and 75% in all patients and pN0M0 cohort, respectively. There was significant difference in OS among each IVC thrombus level cohort (p<0.02). Two-year OS of metastatic RCC patients was 67% and not significantly different when compared to non-metastatic cohort (p=0.12). On multivariate analysis, only sarcomatoid dedifferentiation was associated with OS (p=0.04). Disease-free survival was not significantly different among thrombus-level cohorts (p=0.65). CONCLUSION: Our study suggested that surgical treatment for RCC with IVC thrombus provided acceptable OS outcomes, even in a small volume experience. Although the survival was significantly reduced with higher IVC thrombus level cohort, the level of thrombus itself was not an independent factor. Only sarcomatoid dedifferentiation was a predictor for OS after radical nephrectomy and tumor thrombectomy.

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