Presurgical Pazopanib Improves Surgical Outcomes for Renal Cell Carcinoma With High-level IVC Tumor Thrombosis

In Vivo. 2019 Nov-Dec;33(6):2013-2019. doi: 10.21873/invivo.11698.

Abstract

Background/ Aim: We evaluated surgical outcomes following nephrectomy and thrombectomy with and without presurgical treatment with pazopanib in patients with advanced renal cell carcinoma with inferior vena caval tumor thrombosis.

Materials and methods: We compared surgical outcomes between patients undergoing presurgical treatment with pazopanib vs. surgery-alone in 19 patients who underwent surgery for advanced renal cell carcinoma with high-level inferior vena caval tumor thrombosis at the Kobe University Hospital.

Results: Comparing the presurgical group with the surgery-alone group, respectively, the average operative time was 497 min vs. 627 min (p=0.08); average blood loss was 1,928 ml vs. 7,393 ml (p<0.05); average postoperative hospitalization duration was 15.3 days vs. 21.6 days (p=0.05); and the perioperative complication rate was lower (presurgical: 33% vs. surgery-alone: 50%).

Conclusion: Presurgical treatment with pazopanib decreased surgical difficulty and improved surgical outcomes for advanced renal cell carcinoma with high-level inferior vena caval tumor thrombosis.

Keywords: Inferior vena cava; molecular-targeted therapy; presurgical therapy; renal cell carcinoma; thrombosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / drug therapy*
  • Carcinoma, Renal Cell / surgery*
  • Female
  • Humans
  • Indazoles
  • Kidney Neoplasms / drug therapy*
  • Kidney Neoplasms / surgery*
  • Male
  • Middle Aged
  • Nephrectomy / methods
  • Perioperative Period
  • Pyrimidines / therapeutic use*
  • Retrospective Studies
  • Sulfonamides / therapeutic use*
  • Thrombectomy / methods
  • Treatment Outcome
  • Vena Cava, Inferior / drug effects*
  • Vena Cava, Inferior / surgery
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / surgery

Substances

  • Indazoles
  • Pyrimidines
  • Sulfonamides
  • pazopanib