Dataset Information

Adjuvant instant preoperative renal artery embolization facilitates the radical nephrectomy and thrombectomy in locally advanced renal cancer with venous thrombus: a retrospective study of 54 cases.

ABSTRACT:

Background

The role of renal artery embolization (RAE) in the therapeutic armamentarium is always controversial. The present study aimed to assess the safety and the surgical outcomes of the instant renal artery embolization (I-RAE) prior to nephrectomy and thrombectomy in patients with locally advanced renal cell carcinoma (RCC) with venous thrombus.

Methods

We performed a retrospective analysis of 54 patients treated with nephrectomy and thrombectomy between January 2012 and January 2019. Twenty-four patients were treated with I-RAE before surgery. Thirty patients received surgery alone (non-RAE group). The patient demographics, operation time, blood loss, transfusion requirements, complications, and other surgical parameters were analyzed between the two groups.

Results

The mean tumor size in the I-RAE group was significantly larger than that in the non-RAE group (11.1 cm versus 7.9 cm; p = .001). The mean estimated blood loss was significantly lower in the I-RAE group compared to that in the non-RAE group (596 ml versus 827 ml; p = .015), and the patients in the non-RAE group were more likely to receive blood transfusion (red blood cell, RBC units, 4 U versus 6 U, p = .025; plasma volume, 200 ml versus 400 ml, p = .01). No differences were found in operative duration, ICU stay, perioperative complications, and length of postoperative hospitalization.

Conclusions

Instant preoperative adjuvant renal artery embolization (I-RAE) is a safe technique. It facilitates nephrectomy and thrombectomy by reducing blood loss, transfusion requirements, and complications of delayed operations, providing urologists with a reliable option for treatment of locally advanced RCC with tumor thrombus.

SUBMITTER: Tang G

PROVIDER: S-EPMC7427865 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Adjuvant instant preoperative renal artery embolization facilitates the radical nephrectomy and thrombectomy in locally advanced renal cancer with venous thrombus: a retrospective study of 54 cases.

Tang Guangxin G Chen Xiaoxu X Wang Jianwei J He Wei W Niu Zhihong Z

World journal of surgical oncology 20200814 1

<h4>Background</h4>The role of renal artery embolization (RAE) in the therapeutic armamentarium is always controversial. The present study aimed to assess the safety and the surgical outcomes of the instant renal artery embolization (I-RAE) prior to nephrectomy and thrombectomy in patients with locally advanced renal cell carcinoma (RCC) with venous thrombus.<h4>Methods</h4>We performed a retrospective analysis of 54 patients treated with nephrectomy and thrombectomy between January 2012 and Jan ...[more]

PMID: 32795311

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Project description:BACKGROUND:To explore the influencing factors of perioperative renal function change and their relationship with prognosis on renal cell carcinoma (RCC) patients with tumor thrombus after nephrectomy and thrombectomy. METHODS:The clinical and pathological data of 135 patients with RCC and tumor thrombus, who underwent nephrectomy and thrombectomy at Peking University Third Hospital from May 2015 to July 2018, was retrospectively analyzed. Absolute change in estimated glomerular filtration rate (eGFR) (ACE) and percent change in eGFR (PCE) were calculated by preoperative and postoperative renal function. Linear regression analysis was used to explore the influencing factors of ACE and PCE, and logistic regression analysis was used to explore the influencing factors of worse postoperative renal function [eGFR?60?mL/(min?×?1.73?m^2)]. Cancer-specific survival (CSS) was estimated by Kaplan-Meier method and multivariate Cox regression, which were used to explore the effect of ACE and PCE on prognosis. RESULTS:Of all the 135 patients, 101 patients (74.8%) were male and 34 patients (25.2%) were female. The mean preoperative eGFR was 73.9?±?21.8?mL/(min?×?1.73?m^2) and postoperative eGFR was 69.5?±?25.2?mL/(min?×?1.73?m^2). In multivariate linear regression analysis, preoperative eGFR (P?<?0.001) and pathological type (P?=?0.038) were significant predictive factors of ACE. In aspect of PCE, preoperative eGFR (P?<?0.001) and pathological type (P?=?0.002) were significant predictors. In multivariate logistic regression analysis, preoperative eGFR (P?=?0.016) was the only risk factor of predicting worse postoperative renal function. During follow-up, 22 patients (16.3%) were dead due to RCC. According to ROC analysis, the cut off value of ACE and PCE was 13.9 and 0.16, respectively. ACE>?13.9 and PCE?>?0.16 indicated worse CSS (P?=?0.006 and P?=?0.047, respectively). However, in multivariate Cox regression analysis of several related factors, perinephric tissues invasion (P?=?0.001), sarcomatoid differentiation (P?=?0.001) and ACE>?13.9 (P?=?0.002) were significant prognostic factors for CSS. PCE?>?0.16 seemed to be not (P?=?0.055). CONCLUSION:We explored several clinicopathological risk factors of predicting renal function change and their relationship with prognosis of RCC patients with tumor thrombus after nephrectomy and thrombectomy. The renal function change, which was associated with preoperative eGFR and pathological type, was prognostic risk factor for CSS and ACE>?13.9 indicated the worse prognosis.

Dataset Information

Adjuvant instant preoperative renal artery embolization facilitates the radical nephrectomy and thrombectomy in locally advanced renal cancer with venous thrombus: a retrospective study of 54 cases.

Background

Methods

Results

Conclusions

Publications

Adjuvant instant preoperative renal artery embolization facilitates the radical nephrectomy and thrombectomy in locally advanced renal cancer with venous thrombus: a retrospective study of 54 cases.

Similar Datasets

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