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Increased risk of preoperative venous thromboembolism in patients with renal cell carcinoma and tumor thrombus.

Abstract : BACKGROUND: The clinical impact of a tumor thrombus in renal cell carcinoma (RCC) patients awaiting radical nephrectomy and thrombectomy is unknown. OBJECTIVE: To determine the incidence of venous thromboembolism (VTE) in RCC patients with tumor thrombus prior to nephrectomy. PATIENTS/METHODS: We conducted a retrospective cohort study including all late-stage (stage 3-4 excluding T1-2 N0M0)) RCC patients that underwent a radical nephrectomy at our institution between January 1, 2005 and July 1. Tumor thrombus was defined as the presence of an intra-luminal filling defect in the renal, hepatic, portal or IVC directly extending from a renal mass detected on computed tomography. RESULTS: A total of 176 patients were included in the study. Fifty-three (30.1%) patients had tumor thrombus diagnosed on imaging Three patients with tumor thrombus (5.7%; 95% CI: 1.4 to 16.8%) developed a VTE while awaiting radical nephrectomy whereas none (0%; 95% CI: 0 to 2.9%) of the patients without a tumor thrombus had an event (p = 0.026). All three events were deep vein thrombosis. Time from tumor thrombus diagnosis to VTE was 5, 15 and 21 days. CONCLUSIONS: Tumor thrombus on imaging is a frequent finding among RCC patients awaiting nephrectomy. The presence of tumor thrombus in these patients increases the incidence of pre-operative VTE. This article is protected by copyright. All rights reserved.
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https://hal.univ-brest.fr/hal-00936007
Contributor : Ghislaine Calvez <>
Submitted on : Friday, January 24, 2014 - 12:15:12 PM
Last modification on : Monday, September 23, 2019 - 3:52:04 PM

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Daniel W Yokom, Ryma Ihaddadene, Patricia Moretto, Christina M Canil, Neil Reaume, et al.. Increased risk of preoperative venous thromboembolism in patients with renal cell carcinoma and tumor thrombus.. Journal of Thrombosis and Haemostasis, Wiley, 2014, 12 (2), pp.169-171. ⟨10.1111/jth.12459⟩. ⟨hal-00936007⟩

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