- Tumor thrombus is common in patients with metastatic renal cell carcinoma (mRCC).
- Cytoreductive nephrectomy (CN) is associated with improved OS in patients without thrombus, and those with tumor thrombus limited the renal vein and infradiaphragmatic inferior vena cava (IVC).
- Patient and tumor characteristics influence the receipt of CN.
Why this matters
- Findings suggest CN plays an important part of the multidisciplinary management of complex patients in the era of immunotherapy.
- Study of 8134 patients with mRCC from National Cancer Database.
- Funding: NIHHYB.
- Of 28.7% patients with tumor thrombus, 78.2%, 16.5%, and 5.4% had tumor thrombus in renal vein, infradiaphragmatic IVC, and supradiaphragmatic IVC.
- Black race, Medicaid or no insurance, unknown tumor size, and thrombus involving the supradiaphragmatic IVC were associated with significantly less likelihood of CN (all P<.01>
- Patients with tumor thrombus were more likely to undergo a CN (P<.01 vs those without however rates of cn from to as thrombus level increased.>
- CN was associated with improved OS in patients without thrombus (HR, 0.52; P<.01 with renal vein p or infradiaphragmatic thrombus>
- Retrospective design.