PTU - Polskie Towarzystwo Urologiczne
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Oncological characterization of renal tumor with thrombus extension
Article published in Urologia Polska 2007/60/1.

authors

Jakub Dobruch, Andrzej Borówka, Gerard Grotthuss, Tomasz Dzik
Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego, I Zespół Dydaktyki Urologicznej - Oddział Urologii Międzyleskiego Szpitala Specjalistycznego w Warszawie

keywords

kidney, renal tumor, tumor thrombus

summary

The aim of the study. The aim of the present study was to evaluate oncological characteristics of renal cancer with venous tumor thrombus.
Material and method. Charts of all patients who underwent nephrectomy due to renal tumor from January 2001 to December 2005 were reviewed. Patients were divided into two groups and those with renal cell carcinoma and tumor thrombus in Group I were compared with those without tumor thrombus in Group II.
Results. 239 patients were operated on renal tumor which invaded the venous system in 28 of them (11.7%), (6 (21.4%) women and 22 (78.6%) men) and in 211 (88.3%) of them (83 (39.3%) women and 128 men (60.7%)) did not. Compared with patients without thrombus those with thrombus had larger tumors (7.9 cm vs 4.7 cm, p=0.01). Histological evaluation revealed that clear cell carcinoma predominated in both Groups - it was found in 23 (82%) patients from Group I and in 163 (77.2%) patients from Group II. 17 (60.7%) tumors in Group I and 45 (21.3%) in Group II were classified as Grade 3-4. Capsular penetration and lumph node invasion were found in 13 (46.4%) and 3 (10.7%) patients of Group I and in 12 (5.5%) and 9 (4.3%) patients of Group II, respectively. The histological type did not differ in renal tumor and in its thrombus. The histological grade of thrombus was lower then in renal tumor in 3 patients. In 8 out of 21 cases of tissue necrosis found in the tumor, it was not demonstrated within its thrombus.
Conclusions. Analysis of our experience reveals that renal cell carcinoma with tumor thrombus is more likely to be larger, higher grade and higher stage. Tumor thrombus is more frequently found in clear cell carcinoma cases and its architecture is mainly similar to the primary tumor. The aim of the study. The aim of the present study was to evaluate oncological characteristics of renal cancer with venous tumor thrombus.
Material and method. Charts of all patients who underwent nephrectomy due to renal tumor from January 2001 to December 2005 were reviewed. Patients were divided into two groups and those with renal cell carcinoma and tumor thrombus in Group I were compared with those without tumor thrombus in Group II.
Results. 239 patients were operated on renal tumor which invaded the venous system in 28 of them (11.7%), (6 (21.4%) women and 22 (78.6%) men) and in 211 (88.3%) of them (83 (39.3%) women and 128 men (60.7%)) did not. Compared with patients without thrombus those with thrombus had larger tumors (7.9 cm vs 4.7 cm, p=0.01). Histological evaluation revealed that clear cell carcinoma predominated in both Groups - it was found in 23 (82%) patients from Group I and in 163 (77.2%) patients from Group II. 17 (60.7%) tumors in Group I and 45 (21.3%) in Group II were classified as Grade 3-4. Capsular penetration and lumph node invasion were found in 13 (46.4%) and 3 (10.7%) patients of Group I and in 12 (5.5%) and 9 (4.3%) patients of Group II, respectively. The histological type did not differ in renal tumor and in its thrombus. The histological grade of thrombus was lower then in renal tumor in 3 patients. In 8 out of 21 cases of tissue necrosis found in the tumor, it was not demonstrated within its thrombus.
Conclusions. Analysis of our experience reveals that renal cell carcinoma with tumor thrombus is more likely to be larger, higher grade and higher stage. Tumor thrombus is more frequently found in clear cell carcinoma cases and its architecture is mainly similar to the primary tumor.

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correspondence

Jakub Dobruch
Oddział Urologii
Międzyleski Szpital Specjalistyczny
ul. Bursztynowa 2
04-749 Warszawa
tel. 0503 072 230
kubadobr@wp.pl