Histopathology and outcomes of non-metastatic renal cell carcinoma with inferior vena cava tumor thrombus: systematic review and meta-analysis

Renal cell carcinoma (RCC) accounts for a significant portion of new cancer diagnoses, with a subset presenting with tumor thrombus in the inferior vena cava (IVC), complicating treatment and prognosis. Despite surgical intervention being the standard for non-metastatic RCC with IVC thrombus, the role of minimally invasive techniques and systemic therapies remains underexplored. Here, we systematically review the histopathologic features and oncological outcomes of non-metastatic RCC with IVC thrombus, analyzing data from 19 studies. Our findings indicate a high prevalence of clear cell histology and significant variability in survival outcomes based on histological subtypes and thrombus extent. The study underscores the potential of tailored therapeutic strategies, including neoadjuvant and adjuvant therapies, to improve patient outcomes. These insights contribute to refining treatment protocols and highlight the need for further research into personalized treatment approaches for RCC with IVC involvement.