Article Abstract

Prognostic significance of venous tumor thrombus consistency (solid vs. friable) in patients with renal cell carcinoma: A systematic review and meta-analysis

Authors: Zhiqiang Qin, Ran Li, Yuan Qin, Peng Han, Jingyuan Tang, Lei Zhang, Feng Wang, Xiaokang Qi, Wei Zhang

Abstract

Background: To assess the prognostic value of venous tumor thrombus consistency (VTTC) in patients with renal cell carcinoma (RCC), and the association of RCC clinicopathological variables between friable venous tumor thrombus (VTT) and solid VTT.
Methods: Relevant studies were systematically searched from the databases PubMed, EMBASE, Web of Science and the Cochrane Library up to December 1st, 2017. Data was centrally extracted and analyzed from the previous studies by two independent reviewers. The pooled hazard ratio (HR) and its 95% confidence intervals (CI) were calculated to assess the prognostic impact of VTTC on RCC patients. Besides, the associations between VTTC and clinical parameters of RCC were calculated using the pooled odds ratio (OR) with 95% CI.
Results: Overall, friable VTT is an important adverse predictor of OS in patients with RCC using the Fixed-effort model (pooled HR =1.60; 95% CI, 1.13–2.26). Nevertheless, the results showed that friable VTT was not a significant predictor of CSS in patients with RCC (pooled HR =1.32; 95% CI, 0.88–1.99). Besides, this meta-analysis also investigated the association of RCC clinicopathological variables between friable VTT and solid VTT. Of the selected variables, nodal status, perinephric fat invasion, tumor necrosis, Fuhrman grade, pathologic grade and histological subtype were associated with VTTC.
Conclusions: This meta-analysis indicated a friable VTT might significantly affect the prognosis of the RCC patients with VTTC.