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PURPOSE Previous reports showed that some patients with renal cell carcinoma (RCC) and renal vein tumor thrombus (RVTT) were misdiagnosed pre-operatively. To improve the accuracy of this diagnosis, the clinical characteristics of RCC with missed RVTT diagnosis were analyzed. METHODS We retrospectively reviewed RCC patients with RVTT between January 2000 and December 2015. The survival analysis was estimated using the Kaplan-Meier method. The Cox proportional hazard models were applied to identify risk factors. RESULTS The missed diagnos