{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T12:44:46Z","timestamp":1777207486459,"version":"3.51.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Renal cell carcinoma (RCC) often develops a tumor thrombus extending into the inferior vena cava (IVC). Radical nephrectomy with IVC thrombectomy is the standard treatment, although prognostic factors are yet to be properly established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The objectives of this study were to review the clinicopathological features of surgically treated patients with RCC and IVC thrombus and to investigate potential prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective analysis covered patients with RCC and IVC thrombus who underwent surgical treatment at a tertiary center over 12 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 32 patients included, 56% and 41% had nodal (N1) and metastatic (M1) diseases, respectively. Thrombus level was 1 in 25% and 4 in 21.9% of cases, according to the Mayo classification. The median follow-up was 17.0 months. The median overall survival (OS) was 20.0 months, with a median OS of 36.0 months in M0 patients and 10.0 months in M1 patients (log-rank\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.029). Stage IV disease (T4 and\/or M1 status) (hazard ratio [HR]: 2.85,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.021), fat invasion (HR: 2.52,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.044), positive margins (HR: 2.54,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037), American Society of Anesthesiologists score (HR: 2.59,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033), tumor size &gt;100 mm (HR: 2.538,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033), and higher neutrophil-to-lymphocyte ratio (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.304,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001) were significantly associated with worse OS in univariate analysis. Thrombus level did not impact prognosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Certain clinicopathological factors, but not thrombus level, appear to influence prognosis. Prospective multicentric randomized studies are needed to better stratify patient risk, improve prognostic prediction, and evaluate systemic therapy responses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ua.ua_113_23","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T02:03:16Z","timestamp":1729044196000},"page":"277-283","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Renal cell carcinoma with inferior vena cava thrombus: Survival and prognostic factors in surgically treated patients"],"prefix":"10.4103","volume":"16","author":[{"given":"Miguel","family":"Miranda","sequence":"first","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"}]},{"given":"Joana","family":"Polido","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"}]},{"given":"Miguel","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"}]},{"given":"Filipe","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"}]},{"given":"Tiago","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"}]},{"given":"Tom\u00e9","family":"Lopes","sequence":"additional","affiliation":[{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Lu\u00eds","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Oncology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"},{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"\u00c2ngelo","family":"Nobre","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"},{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Tito Palmela","family":"Leit\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"},{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Lu\u00eds Mendes","family":"Pedro","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"},{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]},{"given":"Jos\u00e9 Palma dos","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Urology, Unidade Local de Sa\u00fade Santa Maria, Lisbon, Portugal"},{"name":"Lisbon School of Medicine, University of Lisbon, Lisbon, Portugal"}]}],"member":"276","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"R1-20260426","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.eururo.2018.08.036","article-title":"Epidemiology of renal cell carcinoma","volume":"75","author":"Capitanio","year":"2019","journal-title":"Eur Urol"},{"key":"R2-20260426","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.eururo.2015.11.034","article-title":"Systematic review of surgical management of nonmetastatic renal cell carcinoma with vena caval thrombus","volume":"70","author":"Lardas","year":"2016","journal-title":"Eur Urol"},{"key":"R3-20260426","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/j.1464-410X.1987.tb04832.x","article-title":"Surgical treatment of renal cancer with vena cava extension","volume":"59","author":"Neves","year":"1987","journal-title":"Br J Urol"},{"key":"R4-20260426","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.eururo.2022.03.006","article-title":"European Association of Urology guidelines on renal cell carcinoma: The 2022 update","volume":"82","author":"Ljungberg","year":"2022","journal-title":"Eur Urol"},{"key":"R5-20260426","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.6004\/jnccn.2020.0043","article-title":"NCCN guidelines insights: Kidney cancer, version 1. 2021","volume":"18","author":"Motzer","year":"2020","journal-title":"J Natl Compr Canc Netw"},{"key":"R6-20260426","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/JU.0000000000001912","article-title":"Renal Mass and Localized Renal Cancer: Evaluation, Management, and Follow-up: AUA Guideline: Part II","volume":"206","author":"Campbell","year":"2021","journal-title":"J Urol"},{"key":"R7-20260426","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/j.eururo.2007.05.009","article-title":"A critical analysis of surgery for kidney cancer with vena cava invasion","volume":"52","author":"Kirkali","year":"2007","journal-title":"Eur Urol"},{"key":"R8-20260426","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/j.eururo.2013.10.029","article-title":"Perioperative outcomes following surgical resection of renal cell carcinoma with inferior vena cava thrombus extending above the hepatic veins: A contemporary multicenter experience","volume":"66","author":"Abel","year":"2014","journal-title":"Eur Urol"},{"key":"R10-20260426","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1097\/01.ju.0000108842.27907.47","article-title":"Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension. Is all T3b the same?","volume":"171","author":"Moinzadeh","year":"2004","journal-title":"J Urol"},{"key":"R11-20260426","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/S0022-5347(01)66415-2","article-title":"Long-term followup after surgical treatment for renal cell carcinoma extending into the right atrium","volume":"155","author":"Glazer","year":"1996","journal-title":"J Urol"},{"key":"R12-20260426","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0090-4295(02)02119-2","article-title":"Long-term experience with management of renal cell carcinoma involving the inferior vena cava","volume":"61","author":"Bissada","year":"2003","journal-title":"Urology"},{"key":"R13-20260426","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/j.1464-410X.2004.04897.x","article-title":"The mayo clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus","volume":"94","author":"Blute","year":"2004","journal-title":"BJU Int"},{"key":"R14-20260426","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1016\/j.juro.2007.05.134","article-title":"Prognostic factors for renal cell carcinoma with tumor thrombus extension","volume":"178","author":"Klatte","year":"2007","journal-title":"J Urol"},{"key":"R15-20260426","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.eururo.2008.07.053","article-title":"Prognostic value of renal vein and inferior vena cava involvement in renal cell carcinoma","volume":"55","author":"Wagner","year":"2009","journal-title":"Eur Urol"},{"key":"R16-20260426","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1097\/01.ju.0000104672.37029.4b","article-title":"Prognostic significance of venous thrombus in renal cell carcinoma. Are renal vein and inferior vena cava involvement different?","volume":"171","author":"Kim","year":"2004","journal-title":"J Urol"},{"key":"R17-20260426","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1016\/j.juro.2007.01.039","article-title":"Renal cell carcinoma with tumor thrombus extension into the vena cava: Prospective long-term followup","volume":"177","author":"Haferkamp","year":"2007","journal-title":"J Urol"},{"key":"R18-20260426","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S0022-5347(17)52730-5","article-title":"The influence of perinephric fat involvement on survival in patients with renal cell carcinoma extending into the inferior vena cava","volume":"128","author":"Heney","year":"1982","journal-title":"J Urol"},{"key":"R19-20260426","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.eururo.2010.10.001","article-title":"Prognostic impact of the 2009 UICC\/AJCC TNM staging system for renal cell carcinoma with venous extension","volume":"59","author":"Mart\u00ednez-Salamanca","year":"2011","journal-title":"Eur Urol"},{"key":"R20-20260426","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.urolonc.2010.11.017","article-title":"Population based analysis of survival in patients with renal cell carcinoma and venous tumor thrombus","volume":"31","author":"Whitson","year":"2013","journal-title":"Urol Oncol"},{"key":"R21-20260426","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.urology.2013.02.034","article-title":"The impact of histology on clinicopathologic outcomes for patients with renal cell carcinoma and venous tumor thrombus: A matched cohort analysis","volume":"82","author":"Kaushik","year":"2013","journal-title":"Urology"},{"key":"R22-20260426","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/bju.12515","article-title":"Positive vascular wall margins have minimal impact on cancer outcomes in patients with non-metastatic renal cell carcinoma (RCC) with tumour thrombus","volume":"114","author":"Abel","year":"2014","journal-title":"BJU Int"},{"key":"R23-20260426","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.juro.2014.03.111","article-title":"Oncologic outcomes following surgical resection of renal cell carcinoma with inferior vena caval thrombus extending above the hepatic veins: A contemporary multicenter cohort","volume":"192","author":"Haddad","year":"2014","journal-title":"J Urol"},{"key":"R24-20260426","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.juro.2014.07.087","article-title":"Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy","volume":"193","author":"Tilki","year":"2015","journal-title":"J Urol"},{"key":"R25-20260426","doi-asserted-by":"crossref","first-page":"e006404","DOI":"10.1136\/bmjopen-2014-006404","article-title":"Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: A meta-analysis","volume":"5","author":"Hu","year":"2015","journal-title":"BMJ Open"},{"key":"R26-20260426","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s12894-020-00665-8","article-title":"Prognostic value of pretreatment neutrophil-to-lymphocyte ratio in renal cell carcinoma: A systematic review and meta-analysis","volume":"20","author":"Shao","year":"2020","journal-title":"BMC Urol"},{"key":"R27-20260426","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1007\/s00262-013-1487-6","article-title":"Emerging role of tumor-associated macrophages as therapeutic targets in patients with metastatic renal cell carcinoma","volume":"62","author":"Santoni","year":"2013","journal-title":"Cancer Immunol Immunother"},{"key":"R28-20260426","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/cam4.574","article-title":"Survival among patients with advanced renal cell carcinoma in the pretargeted versus targeted therapy eras","volume":"5","author":"Li","year":"2016","journal-title":"Cancer Med"},{"key":"R29-20260426","doi-asserted-by":"crossref","first-page":"577.e9","DOI":"10.1016\/j.urolonc.2019.03.009","article-title":"Cytoreductive nephrectomy in patients with metastatic renal cell carcinoma and venous thrombus-trends and effect on overall survival","volume":"37","author":"Lenis","year":"2019","journal-title":"Urol Oncol"},{"key":"R30-20260426","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1097\/01.ju.0000045706.35470.1e","article-title":"Renal cell carcinoma with tumor thrombus extension: Biology, role of nephrectomy and response to immunotherapy","volume":"169","author":"Zisman","year":"2003","journal-title":"J Urol"},{"key":"R31-20260426","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1056\/NEJMoa2106391","article-title":"Adjuvant pembrolizumab after nephrectomy in renal-cell carcinoma","volume":"385","author":"Choueiri","year":"2021","journal-title":"N Engl J Med"}],"container-title":["Urology Annals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ua.ua_113_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T12:06:23Z","timestamp":1777205183000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ua.ua_113_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ua.ua_113_23","relation":{},"ISSN":["0974-7796","0974-7834"],"issn-type":[{"value":"0974-7796","type":"print"},{"value":"0974-7834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2023-11-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}