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Residual tumor thrombus in RCC patients following nephrectomy is a risk factor for VTE, but not for overall survival

Commentary from Professor Susanne Osanto

10th April 2014

A study of the long-term risk of venous thromboembolism (VTE) reported in the Journal of Thrombosis and Haemostasis by Dr. Ihadaddene et al suggests that residual tumor thrombus in RCC patients post-nephrectomy does not predict poor survival. 

Of the 170 stage III-IV surgical renal cell carcinoma patients who underwent nephrectomy 97 (57.1%) had tumor thrombus. Patients with residual tumor thrombus following surgery had a markedly higher risk of developing venous thromboembolism (VTE) during a 2 year follow-up period than those with complete tumor thrombus resection (Hazard Ratio (HR): 8.7; 95% CI: 1.7 to 43.4), and no tumor thrombus (HR: 6.5; 95% CI: 1.7 to 24.7). Importantly, patients with residual tumor thrombus had no worse overall survival. Based on the high risk for subsequent VTE, prophylactic anticoagulants should be considered in these patients.


Reference

The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus

Ihadaddene R, Yokom DW, Le Gal G, Moretto P, Canil CM, Delluc A, Reaume N, Carrier M.

J Thromb Haemost. 2014 Apr 4. [Epub ahead of print]

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