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Clinical Outcomes of Radical Surgery in Patients with Renal Carcinoma and Associated Venous Thrombosis: Single-Center Experience in a Tertiary Care Institution
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  • Bulent Onal,
  • Muhammed Fatih Simsekoglu,
  • Mehmet Hamza Gultekin,
  • Cetin Demirdag,
  • Sinharib Citgez,
  • Ahmet Erozenci
Bulent Onal
Istanbul Universitesi-Cerrahpasa, Urology
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Muhammed Fatih Simsekoglu
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Mehmet Hamza Gultekin
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Cetin Demirdag
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Sinharib Citgez
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Ahmet Erozenci
Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine
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Abstract

Background: Renal carcinoma and associated venous thrombosis cause-specific perioperative and postoperative challenges. We aimed to evaluate the factors affecting clinical outcomes in patients undergoing radical surgery due to renal carcinoma and associated venous thrombosis. Materials and methods: Hospital records were retrospectively reviewed to identify patients with renal carcinoma and associated venous thrombosis treated with radical surgery between 2006 and 2019. Preoperative, perioperative, and postoperative findings were analyzed to determine the associations between clinical and survival outcomes. Overall and disease-free survival was analyzed by the Kaplan-Meier method. Other associated prognostic variables were assessed using univariate and multivariate Cox regression analyses. Results: Thirty-three patients with renal carcinoma and associated venous thrombosis were enrolled for this study. There were 15 (45.4%) patients with level I, five (15.2%) with level II, eight (24.2%) with level III, and five (15.2%) with level IV venous thrombosis according to the Mayo Clinic classification system. The median follow-up was 35.6 months. In the univariate analysis, increased tumor size was associated with poor overall and disease-free survival. Preoperative clinic M1 disease was associated with poor overall survival. A high Mayo Clinic thrombus level was associated with poor disease-free survival. In the multivariate analysis, only tumor size and clinic M1 disease were independently correlated with poor overall survival. No independent statistically significant association was detected between thrombus level and survival outcomes. Conclusions: Although the thrombus level was not associated with overall and disease-free survival, tumor size and clinic M1 disease were found to have an independent prognostic impact on overall survival.

Peer review status:Published

25 Sep 2020Submitted to International Journal of Clinical Practice
26 Sep 2020Assigned to Editor
26 Sep 2020Submission Checks Completed
28 Sep 2020Reviewer(s) Assigned
23 Oct 2020Review(s) Completed, Editorial Evaluation Pending
23 Oct 2020Editorial Decision: Accept
Apr 2021Published in International Journal of Clinical Practice volume 75 issue 4. 10.1111/ijcp.13811