Neoadjuvant targeted molecular therapies in patients undergoing nephrectomy and inferior vena cava thrombectomy: is it useful? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-02

AUTHORS

Pierre Bigot, Tarek Fardoun, Jean Christophe Bernhard, Evanguelos Xylinas, Julien Berger, Morgan Rouprêt, Jean-Baptiste Beauval, Samuel Lagabrielle, Souhil Lebdai, Myriam Ammi, Hervé Baumert, Bernard Escudier, Nicolas Grenier, Jean-François Hétet, Jean-Alexandre Long, Philippe Paparel, Nathalie Rioux-Leclercq, Michel Soulié, Abdel-Rahmène Azzouzi, Karim Bensalah, Jean-Jacques Patard

ABSTRACT

OBJECTIVE: To assess the effect of neoadjuvant targeted molecular therapies (TMTs) on size and level of inferior vena cava tumor thrombi and to evaluate their impact on surgical management. METHODS: We retrospectively analyzed the data of 14 patients treated for a clear cell renal cell carcinoma with inferior vena cava thrombi by neoadjuvant TMT before nephrectomy. Clinical, pathological and perioperative data were gathered retrospectively at each institution. The primitive tumor size and the thrombus size were defined by computed tomography before TMT. The tumor thrombus level was defined according to the Novick's classification. RESULTS: Before TMT, thrombus level was staged I for 1 (7%), II for 10 (72%) and III (21%) for 3 patients. First-line therapy was sunitinib in 11 cases and sorafenib in 3 cases. Median therapy duration was two cycles (1-5). Three patients experienced major adverse effects (grade III) during TMT. Following TMT, 6 (43%) patients had a measurable decrease, 6 (43%) had no change, and 2 (14%) had an increase in the thrombus. One patient (7%) had a downstage of thrombus level, 12 (85%) had stable thrombi, and 1 (7%) had an upstage. Regarding primary tumor, 7 (50%), 5 (36%) and 2 (14%) patients had a decrease, stabilization and an increase in tumor size, respectively. CONCLUSION: Neoadjuvant TMT appears to have limited effects on renal tumor thrombi. This retrospective study failed to demonstrate a significant impact of neoadjuvant TMT on surgical management of clear cell renal cell carcinoma with inferior vena cava tumor thrombi. More... »

PAGES

109-114

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-013-1088-1

DOI

http://dx.doi.org/10.1007/s00345-013-1088-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1043924045

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23624719


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