Postoperative effectiveness and prognostic factors of renal cell carcinoma patients with vein tumor thrombus

Objective To investigate the postoperative effectiveness and prognostic factors for renal cell carcinoma (RCC) patients with venous tumor thrombus after radical nephrectomy and thrombectomy. Methods RCC patients with venous tumor thrombus who were admitted to the Affiliated Hospital of Xuzhou Medical University from January 2007 to December 2018 were enrolled and their clinical data were retrospectively analyzed. The Kaplan-Meier method was used to plot a survival curve. The Cox proportional hazard model was used for univariate and multivariate survival analyses. Results A total of 45 patients were enrolled in the current study, including 29 men (64.4%) and 16 women (35.6%), with 31 cases of open surgery (68.9%) and 14 cases of laparoscopic surgery (31.1%). No tumor thrombus shed, and no serious complications or death were reported during the perioperative period. The 1-, 3-, and 5-year overall survival rates were 86.1%, 65.2%, and 57.7%, respectively. According to univariate analysis, hemoglobin < lower limit of normal (95%CI: 1.688-15.732, P=0.004) and AJCC stages (95% CI: 1.257-7.927, P=0.014) were the factors influencing the overall survival (OS). Based on multivariate analysis, age ≥ 60 years old (95%CI: 1.059-9.818, P=0.039), hemoglobin P=0.021), and AJCC stages (95% CI: 1.030-9.254, P=0.044) were the independent risk factors for OS. Conclusions Radical nephrectomy and thrombectomy have good effectiveness in RCC patients (0-Ⅲ grades) with venous tumor thrombus. Age, hemoglobin level and AJCC stages are the independent risk factors influencing the OS.