The risk of venous thromboembolism in renal cell carcinoma patients with residual tumor thrombus


  • Manuscript handled by: F. R. Rosendaal
  • Final decision: F. R. Rosendaal, 1 April 2014



The clinical importance of tumor thrombus in patients with renal cell carcinoma is unknown. We sought to determine the long-term risk of venous thromboembolism (VTE) in patients with residual tumor thrombus postextraction, and to evaluate the impact of residual tumor thrombus on overall survival.


A cohort study of patients with stage III–IV renal cell carcinoma undergoing nephrectomy was undertaken. The primary endpoint was the risk of VTE during a 2-year follow-up period. The secondary endpoint was 2-year overall survival.


A total of 170 surgical renal cell carcinoma patients were included, 97 (57.1%) of whom had tumor thrombus. Patients with residual tumor thrombus following surgery had a higher risk of developing VTE than those with complete tumor thrombus resection (hazard ratio [HR] 8.7, 95% confidence interval [CI] 1.7–43.4) and no tumor thrombus (HR 6.5, 95% CI 1.7–24.7). Patient with residual tumor thrombus did not have worse overall survival than those with tumor thrombus completely resected or those without tumor thrombus.


The presence of residual tumor thrombus is an important risk factor for VTE among renal cell carcinoma patients.