Presented by: Yu Zhang MD
Peking University Third Hospital

Introduction

To demonstrate the clinical, pathological and prognostic features of invasive parenchyma pyelocaliceal urothelial carcinoma (pUC) with venous thrombus (VT). 

Materials

We conducted a propensity-matched retrospective cohort study containing 23 patients with pUC-VT and 104 patients with pUC only from January 2014 to January 2021. We reported the characteristics of pUC-VT and compared the surgical and oncological outcomes with pUC only. The Pearson chi-square test and Fisher exact test, Wilcoxon rank sum test, Cox proportional hazards regression model and log-rank test were used.

Results

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After matching, 20 patients were matched in each group and no significant differences were found in most baseline characteristics except for tumor diameter (7.5cm vs 4.5 cm, P=0.004). Patients with pUC and VT had more blood loss (400ml vs 50 ml, P=0.004) and higher complication rate (35% vs 5%, P=0.04) than that with pUC only. After a median follow-up of 48.0 mon (IQR 41.0- 59.0 mon) in the pUC with VT group and 58.0 mon (IQR 41.0- 62.0 mon) in the pUC group, the median OS of pUC patients with renal vein thrombus or inferior vena cave thrombus were 13.0 mon (IQR 3.5-13.0 mon) and 4.5 mon (IQR 2.5-13.0 mon), respectively. Patients with pUC and IVC thrombus had worse OS than patients with pUC only (Adjusted HR 2.67, 95%CI 1.06-6.82; P=0.04). 

Conclusion

Radical nephroureterectomy and thrombectomy of pUC with VT is feasible with acceptable surgical outcomes. Long-term survival of pUC with VT patients is poor and multimodality treatment is needed to improve the prognosis.

Funding

None

 

Lead Authors

LuLin Ma, MD
Peking University Third Hospital