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Fate of newly developed pulmonary embolism after surgery for renal cell carcinoma with vena cava thrombus

  • Urology - Original Paper
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Abstract

Purpose

Pulmonary embolism with viable tumor cells developed after surgery for renal cell carcinoma may metastasize to lung. We investigated the incidence and fate of newly developed pulmonary embolism after surgery for renal cell carcinoma with vena cava thrombus.

Methods

Among 4549 renal cell carcinoma patients treated with curative surgery at our institute from 1998 to 2015, 81 non-metastatic renal cell carcinoma patients with vena cava thrombus were included. The clinical course of pulmonary embolism and its impact on oncological outcomes were assessed.

Results

Postoperatively, pulmonary embolism developed in 13 patients (16.0%), who had higher level of vena cava thrombus (p = 0.004), more frequent liver mobilization (p = 0.005), and higher amount of intraoperative transfusion (p = 0.024) than patients without pulmonary embolism. The rate of lung metastasis was similar between patients with and without pulmonary embolism (30.8 vs. 35.3%, p = 1.000). In the multivariate analysis, the significant risk factors for disease recurrence were non-clear cell histology (p = 0.014) and larger primary renal tumor size (p = 0.032). Non-clear cell histology (p = 0.003) was the only significant risk factor for cancer-specific survival. Pulmonary embolism was not associated with both recurrence-free and cancer-specific survival.

Conclusions

Pulmonary embolism after surgery for renal cell carcinoma with vena cava thrombus was not associated with worse oncological outcomes and can be closely followed up with anticoagulation therapy.

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Authors and Affiliations

  1. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Sangjun Yoo, Sang Hoon Song, Dalsan You, Cheryn Song, Jun Hyuk Hong, Choung-Soo Kim, Hanjong Ahn & In Gab Jeong

  2. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Heounjeong Go

Authors
  1. Sangjun Yoo
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  2. Sang Hoon Song
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  3. Heounjeong Go
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  4. Dalsan You
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  5. Cheryn Song
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  6. Jun Hyuk Hong
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  7. Choung-Soo Kim
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  8. Hanjong Ahn
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  9. In Gab Jeong
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Corresponding author

Correspondence to Sang Hoon Song.

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Ethical standards

This study has been approved by the Institutional Review Board and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. IRB waived the mandate for obtaining legally effective informed consent from subjects. No information with the potential to disclose patient identities was included.

Conflicts of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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Cite this article

Yoo, S., Song, S.H., Go, H. et al. Fate of newly developed pulmonary embolism after surgery for renal cell carcinoma with vena cava thrombus. Int Urol Nephrol 49, 1157–1163 (2017). https://doi.org/10.1007/s11255-017-1583-1

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  • DOI: https://doi.org/10.1007/s11255-017-1583-1

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