The goal of this observational study is to establish a preoperative imaging diagnostic model which highly consistent with the histopathological examinations, as well as a accurate and systematic pathological grading standard of inferior vena cava (IVC) vascular wall invasion in renal cell carcinoma (RCC) with tumor thrombus invading vascular wall.The main questions it aims to answer are:
* To establish a preoperative imaging diagnostic model which highly consistent with the histopathological examinations. * To determine what impact does different vascular wall layer invasion make on the long-term prognosis in RCC with IVC tumor thrombus; * To determine which layer invasion according to pathological examination make sense to clinical treatment (can significantly affect prognosis); Participants with IVC vascular wall invasion/ non-invasion are divided into experimental group (invaded group) or control group (non-invaded group) respectively according to pathological examinations, in order to establish a prospective cohort with three-year follow-up. The pathological characteristics of local recurrence and poor prognosis are summarized, and postoperative pathological diagnostic criteria of IVC vascular wall invasion and established. The local recurrence and distant recurrence outcomes are compared between experiment group and control group, in order to analyze the long-term influence of vascular wall invasion. Then the preoperative imaging diagnostic evaluation model will be established.
Adults ≥18 years of age;
Accepted abdominal ultrasonography, contrast-induced ultrasonography, enhanced CT and MRI before the surgery;
Diagnosis of primary renal cell carcinoma with tumor thrombus before and during the surgery;
Received radical nephrectomy and at least one kind of thrombectomy (including IVC incision only, IVC partial resection, IVC diagonal resection, and IVC segmental resection)
Failed to receive standard nephrectomy for any reason;
Attached other addition operations in the surgery;
Received neoadjuvant treatment before the surgery;
Experience any other conditions that may affect the curative effect (e.g. active tuberculosis, autoimmune disease, or oral glucocorticoids treatment);
The groups of cohort will be selected from inhospital patients in Peking University Third Hospital.
Cohort
Prospective
Vascular wall invaded
Diagnostic testInferior vena cava vascular wall is invaded according to pathologic examination on the postoperative tumor thrombus/ vascular wall specimen.
Overall survival
The duration from the date of diagnosis to death or last follow-up, with no restriction on the cause of death.
Clinical manifestation
Clinical manifestation related to the renal carcinoma
Mayo classification
A universal grading system for renal tumor thrombus.
Primary tumor diameter
Diameter of the primary tumor.
Preoperative tumor node metastasis (TNM) stage
TNM stage according to the preoperative imaging.
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