Impact of presurgical systemic therapy on perioperative outcomes of renal cell carcinoma with inferior vena cava tumor thrombus.

IF 2.4 3区医学 Q3 ONCOLOGY International Journal of Clinical Oncology Pub Date : 2024-12-12 DOI:10.1007/s10147-024-02680-3

Kotaro Suzuki, Yasuyoshi Okamura, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Yoji Hyodo, Koji Chiba, Akihisa Yao, Jun Teishima, Hideaki Miyake

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Abstract

Background: Surgery for inferior vena cava tumor thrombus (IVC-TT) in patients with renal cell carcinoma (RCC) is highly invasive and is associated with perioperative mortality. This study aimed to assess the efficacy of presurgical systemic therapy (PT) on perioperative outcomes in RCC patients with IVC-TT.

Methods: A total of 68 patients with right-sided RCC and level ≥ II IVC-TT were included in this study. The tumor response to PT was investigated, and we compared surgical outcomes and perioperative complications between patients with PT (n = 23) and those who underwent immediate surgical resection (non-PT, n = 45).

Results: In the PT group, while 15 patients were treated with tyrosine kinase inhibitors (TKIs) alone, a combination of immune-oncology (IO) therapy and TKIs (IO + TKI) was used in 8 patients. Eleven of 23 (47.8%) patients in the PT group showed a reduction in the level of TT. PT significantly reduced the operation time, intraoperative blood loss, the need for extracorporeal circulation, the incidence of grade ≥ III perioperative complications, and the duration of hospitalization after surgery.

Conclusion: Our findings suggest that PT may be effective in reducing surgical invasiveness in RCC patients with IVC-TT. Further prospective studies are needed to identify the optimal drug regimen for PT and to clarify its survival benefits.

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术前全身治疗对肾细胞癌合并下腔静脉肿瘤血栓围手术期预后的影响。

背景：肾细胞癌（RCC）患者下腔静脉肿瘤血栓（IVC-TT）的手术是高度侵入性的，并且与围手术期死亡率相关。本研究旨在评估术前全身治疗（PT）对RCC伴IVC-TT患者围手术期预后的影响。方法：本研究共纳入68例右侧RCC且IVC-TT水平≥II的患者。我们研究了肿瘤对PT的反应，并比较了PT患者（n = 23）和立即手术切除患者（n = 45）的手术结果和围手术期并发症。结果：PT组15例患者单用酪氨酸激酶抑制剂（TKIs）治疗，8例患者采用免疫肿瘤学（IO）联合TKIs （IO + TKI）治疗。PT组23例患者中有11例（47.8%）显示TT水平降低。PT可显著减少手术时间、术中出血量、体外循环需氧量、≥III级围手术期并发症发生率及术后住院时间。结论：我们的研究结果表明，PT可能有效地减少RCC合并IVC-TT患者的手术侵袭性。需要进一步的前瞻性研究来确定PT的最佳药物方案并阐明其生存益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Oncology 医学-肿瘤学

CiteScore

6.80

自引率

3.00%

发文量

175

审稿时长

2 months

期刊介绍： The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.