Work

Tumor-informed ctDNA surveillance after radical nephrectomy and level IV IVC thrombectomy for clear cell renal cell carcinoma: Early detection of molecular residual disease

Year: 2026

Type: article

Abstract: Renal cell carcinoma with level IV inferior vena cava tumor thrombus is rare and associated with high recurrence risk despite complete resection. We report an 80-year-old man who underwent radical nephrectomy and inferior vena cava thrombectomy with initial negative postoperative imaging. One year later, imaging findings were equivocal, but tumor-informed circulating tumor DNA was detectable, prompting early surgical resection of recurrent disease. Postoperatively, circulating tumor DNA became undetectable. This case highlights the potential role of tumor-informed circulating tumor DNA surveillance in detecting molecular residual disease and guiding management in high-risk renal cell carcinoma. • Level IV IVC thrombus RCC was successfully managed with radical nephrectomy and thrombectomy • Tumor-informed ctDNA detected molecular residual disease despite equivocal imaging • ctDNA positivity prompted early surgical intervention for RCC recurrence • Post-resection ctDNA clearance correlated with molecular remission • ctDNA may complement imaging for surveillance in high-risk renal cell carcinoma

Source: Urology Case Reports

DOI: 10.1016/j.eucr.2026.103460

Authors: Mahdi Hemmati Ghavshough, Melinda Z. Fu, Disha Patel, Vignesh T. Packiam, Saum Ghodoussipour

Institution: Rutgers Cancer Institute

Language: English

Topic: Renal cell carcinoma treatment

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,160