Survival outcomes after surgical treatment for non-clear cell renal cell carcinoma with tumor thrombus extension: a population-based cohort study.

Joseph G Cheaib, Carlos A Rivera López, Craig Cronin, Mark N Alshak, Adnan El-Achkar, Sunil H Patel, Nirmish Singla

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Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Joseph G CheaibDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA. jcheaib1@jhu.edu.ORCID http://orcid.org/0000-0003-1679-2682

Carlos A Rivera LópezDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Craig CroninDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Mark N AlshakDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Adnan El-AchkarDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Sunil H PatelDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Nirmish SinglaDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street / Park 200, Baltimore, MD, 21287, USA.

Funding

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6 · The paper itself

Abstract

purposeTo characterize the impact of histology on survival outcomes in a population-based cohort of patients treated surgically for renal cell carcinoma (RCC) with tumor thrombus (TT) extension.

methodsThe Surveillance, Epidemiology, and End Results database was used to identify adult patients with node-negative, non-metastatic RCC and TT who underwent surgical resection between 2010 and 2021. The Kaplan-Meier method and log-rank test were used to compare overall survival (OS) probabilities for clear cell RCC (ccRCC) versus non-clear cell RCC (nccRCC). Cox and Fine-Gray competing risk regression analyses were performed to evaluate histology-specific risks of all-cause and cancer-specific mortality (CSM), respectively.

resultsA total of 6553 patients were included, of whom 381 (5.8%) had nccRCC. Over a median follow up of 3.2 years, 1757 (26.8%) deaths occurred, of which 1165 (66.3%) were attributable to RCC. There was no difference in OS between patients with ccRCC versus nccRCC (5-year OS: 70.9% versus 65.6%, p = 0.09). Histologic subtype was not significantly predictive of all-cause mortality on multivariable Cox regression (hazard ratio (HR) = 1.12, 95% confidence interval (CI): 0.92-1.37, p = 0.3). On multivariable competing risk regression analysis, nccRCC was not associated with increased hazard of CSM (HR = 1.24, 95% CI: 0.96-1.58, p = 0.09) compared to ccRCC. Similar findings were noted in the subcohort of patients with TT extension to the IVC.

conclusionsNo statistically significant differences in survival outcomes by histology were detected among patients with TT arising from RCC after definitive surgical resection. Multimodal treatment strategies, particularly for nccRCC, are needed to further improve outcomes in these patients.

Indexed as

Carcinoma, Renal CellKidney NeoplasmsNephrectomyThrombosisAgedCohort StudiesFemaleHumansMaleMiddle AgedNeoplasm InvasivenessRetrospective StudiesSEER ProgramSurvival RateHistologyNephrectomyRenal cell carcinomaSurvivalTumor thrombus

Identifiers

PMID41793499

DOI10.1007/s00345-026-06285-5

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