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Therefore, further studies are required to better characterize this patient population, especially from the clinicopathologic standpoint. A comprehensive review of patients with RCC and vena cava involvement managed at our institution from 2014 to 2022 was performed. Multiple clinicopathologic parameters including follow-up were obtained. A total of 114 patients were identified. The mean patient age was 63 years (range: 30-84 years). The cohort consisted of 78\/114 (68%) males and 36\/114 (32%) females. The mean primary tumor size (excluding tumor thrombus) was 11\u2005cm. The majority of tumors (104\/114, 91%) were unifocal. Tumor stages were categorized as follows: pT3b (51\/114, 44%), pT3c (52\/114, 46%), and pT4 (11\/114, 10%). Most of the tumors were clear cell RCC 89\/114 (78%), although other more aggressive RCC subtypes were also present. Most tumors were WHO\/ISUP grade 3 (44\/114, 39%) or 4 (67\/114, 59%) with sarcomatoid differentiation present in 39\/67 (58%). Necrosis was present in 94\/114 (82%) tumors. Twenty-three of 114 (20%) tumors were categorized as pM1 and the ipsilateral adrenal gland was the most common site of metastasis. Of the 91 patients categorized as pM, not applicable at nephrectomy, 42\/91 (46%) subsequently developed metastasis, most frequently to the lung. Of all patients, only 16\/114 (14%) had positive vascular margins and 7\/114 (6%) had positive soft tissue margins despite having very advanced disease and a subset considered inoperable at other centers.<\/jats:p>","DOI":"10.1177\/10668969231177264","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T06:10:10Z","timestamp":1686550210000},"page":"279-285","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A Contemporary Clinicopathologic Analysis of Patients With Renal Cell Carcinoma and Vena Cava Involvement"],"prefix":"10.1177","volume":"32","author":[{"given":"Omar M.","family":"Al-Rusan","sequence":"first","affiliation":[{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dattatraya","family":"Patil","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viraj A.","family":"Master","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine"},{"name":"Winship Cancer Institute of Emory University, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5712-8134","authenticated-orcid":false,"given":"Adeboye O.","family":"Osunkoya","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine"},{"name":"Emory University School of Medicine"},{"name":"Winship Cancer Institute of Emory University, Atlanta, GA, USA"},{"name":"Department of Pathology, Veterans Affairs Medical Center, Decatur, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"https:\/\/www.cancer.org\/content\/dam\/cancer-org\/research\/cancer-facts-and-statistics\/annual-cancer-facts-and-figures\/2022\/2022-cancer-facts-and-figures.pdf"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1279"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40644-018-0150-z"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2022.07.011"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3400\/avd.cr.11.00067"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/bco2.154"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau-22-128"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002829"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11174.x"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-20839-4_6"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2021.12.013"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/iju.IJU_13_21"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.06826.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756287215576443"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-022-01120-x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2019.06.15"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030808"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.12.011"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2017.01.009"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2015.10.009"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24395"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756287218794094"},{"issue":"4","key":"e_1_3_2_24_2","first-page":"103","article-title":"Dissecting the role of lymphadenectomy in the management of renal cell carcinoma: past, present, and future","volume":"18","author":"Kaldany A","year":"2020","unstructured":"Kaldany A, Leopold ZR, Kim JE, et al. 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