scholarly journals A case of mixed acinar-endocrine carcinoma with multiple hepatic metastasies and splenic venous tumor thrombus

2012 ◽  
Vol 73 (1) ◽  
pp. 130-134
Author(s):  
Hirotada KITTAKA ◽  
Hidenori TAKAHASHI ◽  
Hiroaki OHIGASHI ◽  
Osamu ISHIKAWA ◽  
Yasuhiko TOMITA ◽  
...  
Keyword(s):  
Tumor Thrombus ◽  
Endocrine Carcinoma ◽  
Venous Tumor Thrombus

Survival analysis of Renal Cell Carcinoma with venous tumor thrombus: A single centre 20-yr experience

2021 ◽  
Vol 79 ◽  
pp. S863
Author(s):  
M.L. Righetto ◽  
M. Mancini ◽  
M. Daniele ◽  
A. Morlacco ◽  
G. Novara ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Survival Analysis ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Single Centre ◽  
Venous Tumor Thrombus

NAXIVA: A phase II neoadjuvant study of axitinib for reducing extent of venous tumor thrombus in clear cell renal cell cancer (RCC) with venous invasion.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 275-275
Author(s):  
Grant D. Stewart ◽  
Sarah J. Welsh ◽  
Stephan Ursprung ◽  
Ferdia Gallagher ◽  
Iosif Mendichovszky ◽  
...  
Keyword(s):  
Renal Cell Cancer ◽  
Surgical Approach ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Response Rate ◽  
Clear Cell ◽  
Cell Cancer ◽  
Surgical Morbidity ◽  
Venous Tumor Thrombus ◽  
Extent Of Surgery

275 Background: Venous tumor thrombus (VTT) extension occurs in 4-15% cases of renal cell cancer (RCC). The Mayo classification distinguishes 4 levels of VTT extension between the renal vein and supradiaphragmatic inferior vena cava (IVC). Although surgery is performed with curative intent, mortality is high (5-15%) with complications increasing with the level of the VTT. 5-year survival rates are poor; ~40-65% in non-metastatic RCC. It is hypothesised that neoadjuvant targeted therapy could downstage the VTT reducing the extent of surgery, leading to reduced surgical morbidity and mortality, and increased survival. However, level I or II evidence is lacking. NAXIVA provides the first level II evidence in this patient group, assessing the response of VTT to axitinib. Extensive translational sampling will provide in depth interrogation of VTT (using genomics, proteomics, immunophenotyping and metabolomics) to examine the role of the tumor microenvironment of VTT and response to axitinib. Methods: NAXIVA was a single arm, single agent, multi-center phase 2 feasibility study of axitinib in patients with both metastatic and non-metastatic clear cell RCC prior to nephrectomy and thrombectomy. A Simon two stage minimax design was adopted and the trial designed for adequate power to distinguish a <5% from a >25% improvement in the Mayo VTT level. 21 patients were recruited over a 24 month period between 15/Dec/2017 and 06/Jan/2020 at 5 sites across the UK. Patients were treated with 8 weeks of axitinib (starting dose 5mg bd, increasing to 10mg bd as tolerated) prior to planned surgery. The primary endpoint was the percentage of evaluable patients with an improvement in VTT according to the Mayo classification (assessed using MRI abdomen scans at screening and week 9, prior to surgery. Secondary endpoints were percentage change in surgical approach, percentage change in VTT height, response rate (by RECIST) and evaluation of surgical morbidity assessed by Clavien-Dindo classification. Results: The percentage of evaluable patients with an improvement in VTT according to the Mayo classification was 26.58% [80% CI: 15.76%, 39.74%] (6 of 21 evaluable patients). 35.29% (6 of 17 patients who progressed to surgery) had a change in surgical approach to a less invasive option. There was a median percentage reduction in VTT height of 21.49% (SD=27.60%). The response rate (by RECIST) in the evaluable population was 61.90% SD, 14.29% PR, 9.52% PD. In terms of surgical morbidity 11.76% (2 of 17 patients who progressed to surgery) experienced a Clavien-Dindo 3 or greater complication (0 CD3, 1 CD4, 1 CD5). Conclusions: NAXIVA provides unique prospective data on the feasibility of neoadjuvant axitinib administration to down stage IVC VTT and reduce the extent of surgery. Work is ongoing to establish predictors of response. Clinical trial information: NCT03494816 .

scholarly journals Outcomes of Renal Cell Carcinoma with Associated Venous Tumor Thrombus: Experience from a Large Cohort and Short Time Span in a Single Center

2020 ◽  
Author(s):  
Zhigang Chen ◽  
Feilong Yang ◽  
Liyuan Ge ◽  
Min Qiu ◽  
Zhuo Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Lymph Node ◽  
Renal Cell ◽  
Tumor Necrosis ◽  
Tumor Thrombus ◽  
Positive Lymph Node ◽  
Venous Tumor Thrombus ◽  
Perinephric Fat ◽  
Sarcomatoid Differentiation

Abstract Background: The surgical management and outcomes of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) have been reported in limited sample size, and there remain discrepancies over the factors that influence oncologic outcomes after radical nephrectomy with thrombectomy (RNTE).The aim of the study was to analyze the outcomes of the patients with RCC with VTT in our institution and identify the independent prognostic factors. Methods: Patients with RCC with VTT were enrolled for the study from February 2015 to December 2018. All patients underwent RNTE. Clinical data were compared using the chi-square and Fisher’s exact tests. Over-all survival (OS) was estimated using the Kaplan-Meier method. Univariable and multivariable survival analyses were performed using COX.Results: 121 patients (91 men & 30 women) were identified with a mean age of (59.3±10.8) years. VTT level was 0 in 25 patients, I in 20, II in 50, III in 12 and IV in 14. The mean follow-up time was (25.7±14.6) months. During the follow-up period, 50 (41.3%) patients died and 69 (57.0%) patients experienced recurrence or metastasis. The 3-year and 5-year OS rate were 57.8% and 38.9%. Among the several factors examined, positive lymph node (P=0.008), tumor necrosis (P =0.022), sarcomatoid differentiation (P <0.001) and perinephric fat invasion (P =0.041) were demonstrated as independent significant risk factors on multivariate analysis. Conclusion: The OS was poor for patients with RCC with VTT. Rather than VTT level, positive lymph node, tumor necrosis, sarcomatoid differentiation and perinephric fat invasion were independent prognostic predictors.

scholarly journals Surgical Techniques for Dealing with Intraluminal Thrombus of Great Vessels in Advanced Differentiated Thyroid Carcinoma

2017 ◽  
Vol 9 (3) ◽  
pp. 115-117
Author(s):  
Pooja Ramakant ◽  
Mallika Dhanda ◽  
Akshay Anand ◽  
Devenraj Vijayant ◽  
Abhinav A Sonkar ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
Surgical Techniques ◽  
Differentiated Thyroid Carcinoma ◽  
Fogarty Catheter ◽  
Intraluminal Thrombus ◽  
Great Vessels ◽  
Venous Tumor Thrombus

ABSTRACT Aim We aim to define and refine the surgical technique for dealing with intraluminal thrombus of great vessels in advanced differentiated thyroid carcinoma (DTC) to reduce the morbidity. Background Venous tumor thrombus from DTC is a rare occurrence with sequelae that cause increased morbidity and early mortality. Management of such patients poses a challenge to surgeons. Materials and methods We define the surgical planning and road map for surgical management of advanced DTC with tumor thrombus involving the internal jugular vein (IJV) and superior vena cava (SVC) by sacrificing one IJV and retrieving the thrombus from the SVC by Fogarty catheter. This technique has minimal morbidity with good outcome. Conclusion By appropriate planning and meticulous surgical techniques, we can aggressively manage patients of advanced DTC with venous tumor thrombus and reduce the morbidity. Clinical significance By surgical techniques leading to complete surgical resections and saving native vital structures, we can aim for successful aggressive surgical management of advanced DTC with venous tumor thrombus. How to cite this article Dhanda M, Anand A, Vijayant D, Sonkar AA, Singh KR, Ramakant P, Mishra A. Surgical Techniques for Dealing with Intraluminal Thrombus of Great Vessels in Advanced Differentiated Thyroid Carcinoma. World J Endoc Surg 2017;9(3):115-117.

1801 COMPLICATIONS AND OUTCOMES FOR PATIENTS WITH RENAL CELL CARCINOMA AND VENOUS TUMOR THROMBUS: RESULTS FROM THE MAYO CLINIC

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Simon Kim ◽  
Stephen Boorjian ◽  
R. Houston Thompson ◽  
Christopher Weight ◽  
Jeffrey Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Mayo Clinic ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Venous Tumor Thrombus
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