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PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics

PURPOSE: To explore the different treatment strategies for urinary tumors with Mayo IV thrombus. MATERIALS AND METHODS: We retrospectively analyzed the patients with Mayo IV thrombus in Peking University Third Hospital from January 2014 to April 2021. We used the Peking University Third Hospital (PU...

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Autores principales: Liu, Zhuo, Li, Yuxuan, Zhang, Yu, Zhao, Xun, Ge, Liyuan, Tang, Shiying, Hong, Peng, Zhang, Shudong, Tian, Xiaojun, Wang, Shumin, Liu, Cheng, Zhang, Hongxian, Ma, Lulin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770268/
https://www.ncbi.nlm.nih.gov/pubmed/35070959
http://dx.doi.org/10.3389/fonc.2021.735145
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author Liu, Zhuo
Li, Yuxuan
Zhang, Yu
Zhao, Xun
Ge, Liyuan
Tang, Shiying
Hong, Peng
Zhang, Shudong
Tian, Xiaojun
Wang, Shumin
Liu, Cheng
Zhang, Hongxian
Ma, Lulin
author_facet Liu, Zhuo
Li, Yuxuan
Zhang, Yu
Zhao, Xun
Ge, Liyuan
Tang, Shiying
Hong, Peng
Zhang, Shudong
Tian, Xiaojun
Wang, Shumin
Liu, Cheng
Zhang, Hongxian
Ma, Lulin
author_sort Liu, Zhuo
collection PubMed
description PURPOSE: To explore the different treatment strategies for urinary tumors with Mayo IV thrombus. MATERIALS AND METHODS: We retrospectively analyzed the patients with Mayo IV thrombus in Peking University Third Hospital from January 2014 to April 2021. We used the Peking University Third Hospital (PUTH) grading system to classify urinary tumors with supradiaphragmatic thrombus. PUTH-A referred to the filled thrombus whose tip just reached above the diaphragm, or the thrombus entering the right atrium (< 2cm). PUTH-B referred to the filled thrombus entering the right atrium (> 2cm), or the thrombus invading the wall of the inferior pericardial vena cava. Detailed techniques were described for various scenarios. Clinicopathological data and perioperative outcomes were reported. Group difference statistical analysis was performed. RESULTS: A total of 26 cases of urinary tumors with supradiaphragmatic IVC thrombus (Mayo grade IV) underwent treatment were enrolled in this study. 19 patients in the PUTH-A group received the open approach without sternotomy and cardiopulmonary bypass. Seven patients in the PUTH-B group received open thoracotomy assisted by cardiopulmonary bypass. No intraoperative death occurred. After 56 months of follow-up, 46.2% (12 of 26) patients died of all causes. Estimated 1-year, 2-year, and 3-year overall survival were 72.0% (95% CI, 54.4%-89.6%), 58.2% (95% CI, 38.0%-78.4%), and 52.4% (95% CI, 31.2%-73.6%), respectively. CONCLUSIONS: We introduced the PUTH grading system for the characteristics of urinary tumors with supradiaphragmatic tumor thrombus, and selected different surgical techniques according to different classifications. This grading system was relatively feasible and effective.
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spelling pubmed-87702682022-01-21 PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics Liu, Zhuo Li, Yuxuan Zhang, Yu Zhao, Xun Ge, Liyuan Tang, Shiying Hong, Peng Zhang, Shudong Tian, Xiaojun Wang, Shumin Liu, Cheng Zhang, Hongxian Ma, Lulin Front Oncol Oncology PURPOSE: To explore the different treatment strategies for urinary tumors with Mayo IV thrombus. MATERIALS AND METHODS: We retrospectively analyzed the patients with Mayo IV thrombus in Peking University Third Hospital from January 2014 to April 2021. We used the Peking University Third Hospital (PUTH) grading system to classify urinary tumors with supradiaphragmatic thrombus. PUTH-A referred to the filled thrombus whose tip just reached above the diaphragm, or the thrombus entering the right atrium (< 2cm). PUTH-B referred to the filled thrombus entering the right atrium (> 2cm), or the thrombus invading the wall of the inferior pericardial vena cava. Detailed techniques were described for various scenarios. Clinicopathological data and perioperative outcomes were reported. Group difference statistical analysis was performed. RESULTS: A total of 26 cases of urinary tumors with supradiaphragmatic IVC thrombus (Mayo grade IV) underwent treatment were enrolled in this study. 19 patients in the PUTH-A group received the open approach without sternotomy and cardiopulmonary bypass. Seven patients in the PUTH-B group received open thoracotomy assisted by cardiopulmonary bypass. No intraoperative death occurred. After 56 months of follow-up, 46.2% (12 of 26) patients died of all causes. Estimated 1-year, 2-year, and 3-year overall survival were 72.0% (95% CI, 54.4%-89.6%), 58.2% (95% CI, 38.0%-78.4%), and 52.4% (95% CI, 31.2%-73.6%), respectively. CONCLUSIONS: We introduced the PUTH grading system for the characteristics of urinary tumors with supradiaphragmatic tumor thrombus, and selected different surgical techniques according to different classifications. This grading system was relatively feasible and effective. Frontiers Media S.A. 2022-01-06 /pmc/articles/PMC8770268/ /pubmed/35070959 http://dx.doi.org/10.3389/fonc.2021.735145 Text en Copyright © 2022 Liu, Li, Zhang, Zhao, Ge, Tang, Hong, Zhang, Tian, Wang, Liu, Zhang and Ma https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Liu, Zhuo
Li, Yuxuan
Zhang, Yu
Zhao, Xun
Ge, Liyuan
Tang, Shiying
Hong, Peng
Zhang, Shudong
Tian, Xiaojun
Wang, Shumin
Liu, Cheng
Zhang, Hongxian
Ma, Lulin
PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title_full PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title_fullStr PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title_full_unstemmed PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title_short PUTH Grading System for Urinary Tumor With Supradiaphragmatic Tumor Thrombus: Different Surgical Techniques for Different Tumor Characteristics
title_sort puth grading system for urinary tumor with supradiaphragmatic tumor thrombus: different surgical techniques for different tumor characteristics
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770268/
https://www.ncbi.nlm.nih.gov/pubmed/35070959
http://dx.doi.org/10.3389/fonc.2021.735145
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