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Limited benefit of targeted molecular therapy for inferior vena cava thrombus associated with renal cell carcinoma

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Abstract

Background

The clinical benefit of targeted molecular therapy (TMT) for an inferior vena cava (IVC) tumor thrombus associated with renal cell carcinoma (RCC) is unclear. The aim of the present study was to assess the change in IVC thrombus height during TMT and to identify the factors associated with the effect of TMT on an IVC thrombus in RCC patients.

Methods

The present study retrospectively analyzed 21 patients with an IVC thrombus who were treated with TMT at our hospital. Thrombus height and level before and after TMT were assessed using CT or MRI. Furthermore, we examined the factors associated with the effect of TMT on the IVC thrombus.

Results

The tumor thrombus level before TMT was I in 2 patients (10%), II in 10 (47%), III in 4 (19%), and IV in 5 (24%). Following TMT, the tumor thrombus height decreased in 16 patients (76%), and the mean decrease was 17 mm. The tumor thrombus height increased in 5 patients (24%), and the mean increase was 30 mm. The tumor thrombus level decreased in 4 patients (19%), remained stable in 15 patients (71%), and increased in 2 patients (10%). We found that the clinical nodal stage (p = 0.025) was significantly associated with and the serum neutrophil count (p = 0.067) tended to be associated with the reduction in the IVC thrombus.

Conclusion

The clinical benefit of TMT for an IVC thrombus associated with RCC is limited.

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Acknowledgements

The authors thank Satoru Shimizu for providing advice on statistical analysis and Noriko Hata for secretarial assistance.

Author information

Correspondence to Tsunenori Kondo.

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Conflict of interest

Tsunenori Kondo received honoraria from Bayer Yakuhin Ltd., Pfizer, and Novartis. All other authors declare no conflicts of interest with regard to this study.

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Fukuda, H., Kondo, T., Takagi, T. et al. Limited benefit of targeted molecular therapy for inferior vena cava thrombus associated with renal cell carcinoma. Int J Clin Oncol 22, 767–773 (2017). https://doi.org/10.1007/s10147-017-1119-9

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Keywords

  • Renal cell carcinoma
  • Tumor thrombus
  • Targeted molecular therapy