Dr. Vitaly Margulis performing a kidney resection.

DALLAS – May 24, 2018 – The nationally recognized Kidney Cancer Program at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center led a team of investigators who identified a new way to help doctors determine the prognosis for patients with stage 3 kidney cancer, which has important implications for decisions about surgery and inclusion in clinical trials.

Patients with stage 3 kidney cancer have rates of recurrence after surgery that vary widely from 20 to 60 percent. To help identify factors that can affect recurrence, Dr. Vitaly Margulis, Associate Professor of Urology, and Dr. Michael Wait, Professor of Cardiovascular and Thoracic Surgery, led a research team of top-tier investigators from Mayo Clinic, MD Anderson Cancer Center, Emory University, Indiana University, and the University of Wisconsin.

Stage 3 kidney tumors are characterized by invasion, and the team focused on a subset of tumors that invaded the largest vein of the body, the inferior vena cava. In these patients, kidney cancer may travel along the vena cava all the way to the heart. In up to half of these patients, the tumor inside the vena cava can trigger the development of a blood clot, but it was previously unclear whether blood clot development impacts cancer survival rates.  

The UT Southwestern-led team found that patients whose tumors triggered a blood clot had a fourfold higher chance of dying from their kidney cancer.

Published in Urology this year, the study followed 446 patients with kidney tumors that invaded the vena cava and who were treated with surgery to remove the affected kidney. The patients were split into two groups – those who developed a blood clot (174) and those who did not (272). The investigators found that the presence of a blood clot was associated with a more advanced stage of the disease, more complications during surgery, and increased risk of dying from the kidney cancer.

Because a blood clot can be easily identified by MRI, this study has revealed a useful and powerful marker that will help doctors better understand their patients’ tumors. 

“These important findings provide a new radiological marker for counseling patients and building the most effective, interdisciplinary treatment plans,” said Dr. Margulis, corresponding author of the study. “The results will help patients in making decisions about surgery, as well as participation in advanced clinical trials available at UT Southwestern.”

“The remarkable skill of our surgeons together with novel treatment approaches we pioneered using stereotactic radiation and the availability of clinical trials makes UT Southwestern an ideal place for patients with these challenging tumors,” said Dr. James Brugarolas, Professor of Internal Medicine and Director of the Kidney Cancer Program, who holds the Sherry Wigley Crow Cancer Research Endowed Chair in Honor of Robert Lewis Kirby, M.D.

The UTSW team is supported in part by a Specialized Program of Research Excellence (SPORE) award from the National Cancer Institute, one of two such awards for kidney cancer in the country.

Simmons Cancer Center, the only National Cancer Institute-designated Comprehensive Cancer Center in North Texas and one of just 49 NCI-designated Comprehensive Cancer Centers in the nation, includes 13 major cancer care programs. In addition, the Center’s education and training programs support and develop the next generation of cancer researchers and clinicians. The Simmons Cancer Center is among only 30 U.S. cancer research centers to be designated by the NCI as a National Clinical Trials Network Lead Academic Participating Site.

About UT Southwestern Medical Center

UT Southwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 22 members of the National Academy of Sciences, 16 members of the National Academy of Medicine, and 15 Howard Hughes Medical Institute Investigators. The faculty of more than 2,700 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in about 80 specialties to more than 100,000 hospitalized patients, 600,000 emergency room cases, and oversee approximately 2.2 million outpatient visits a year.