Risk factors for incident venous thromboembolism in patients with renal tumor and inferior vena cava tumor thrombus: a retrospective case–control study

Abstract

Background: Venous thromboembolism (VTE) is a principal cause of mortality and adverse oncologic outcomes in patients with renal tumor and inferior vena cava tumor thrombus (RT-IVCTT). However, the preoperative thrombotic risk factors in these patients remain not fully characterized. Objectives: To identify preoperative thrombotic risk factors in patients with RT-IVCTT. Patients/Methods: Two hundred fifty-seven consecutive postsurgical patients with RT-IVCTT aged 18–86 years were enrolled between January 2008 and September 2022. Clinicopathological variables were retrospectively reviewed. A multivariate logistic regression model was performed. Preoperative hemoglobin, neutrophils, and serum albumin levels were analyzed as both continuous and categorical variables. Results: VTE was identified in 63 patients (24.5%). On both continuously and categorically coded variables, advanced IVC thrombus (OR 3.2, 95% CI: 1.4–7.0; OR 2.7, 95% CI: 1.2–6.1), renal sinus fat invasion (OR 3.4, 95% CI: 1.6–7.0; OR 3.7, 95% CI: 1.8–7.7), IVC wall invasion (OR 3.6, 95% CI: 1.6–7.9; OR 4.3, 95% CI: 1.9–10.0), IVC blockage status of greater than 75% (OR 5.2, 95% CI: 1.7–15.8; OR 6.1, 95% CI: 1.9–19.7), and higher neutrophils (OR 1.3, 95% CI: 1.0–1.7; OR 2.4, 95% CI: 1.1–5.4) were significantly associated with increased VTE risk in patients with RT-IVCTT. Except hemoglobin, categorically coded serum albumin (OR 0.36, 95% CI: 0.17–0.75) was validated as an independent risk factor for VTE. Conclusions: This study provided an insight of risk factors contributing to preoperative VTE in patients with RT-IVCTT, which may be beneficial for optimizing strategies to manage VTE in clinical practice.