Renal Cell Carcinoma Associated with Tumor Thrombus in the Inferior Vena Cava: Surgical Strategies

Zini, Luca; Haulon, Stéphan; Decoene, Christophe; Amara, Nordine; Villers, Arnauld; Biserte, J; Leroy, Xavier; Koussa, Mohamed

doi:10.1007/s10016-005-5031-9

Cited by 42 publications

(15 citation statements)

References 29 publications

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Section: Differentiation Of Tnm Classes T3b and T3cmentioning

confidence: 99%

“…Zini and co-workers [22] re-examined ten patients with RCC tumor thrombus extending into the RV (n=1), IVC below the liver (n=1), IVC at the level of the liver (n=3), or above the diaphragm (n=5). One patient died peri-operatively, two died during follow-up, and one survived with tumor recurrence, while the remaining six were tumor-free after a median interval of 9.7 months [22]. Jibiki and co-workers [23] report on 30 patients with RCC and tumor thrombus extending into the IVC who underwent radical nephrectomy and removal of thrombus with (n=11) or without (n=19) IVC resection between 1980 and 2001.…”

Section: Differentiation Of Tnm Classes T3b and T3cmentioning

confidence: 99%

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Staging of renal cell carcinoma

et al. 2007

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As in other malignant tumors, prognosis in renal cell carcinoma (RCC) depends on tumor extent and metastasis at the time of primary diagnosis. Staging systems formalize the way in which the extent of RCC is being described and classified. Primary staging of RCC aims at evaluating surgical options. Since surgical excision, which is the mainstay of therapy in non-metastatic RCC, and, recently, minimally invasive ablation methods have evolved significantly over the last decades, staging systems continue to evolve along the way. The 40-year-old Robson classification has been replaced with the TNM classification of RCC, because the latter adapts more easily to changing patterns of diagnosis and therapy. Modern cross-sectional imaging methods, such as multidetector-row computed tomography (MDCT), and magnetic resonance imaging (MRI), perform highly in T-staging of local tumor extent and M-staging of distant metastasis. However, both MDCT and MRI perform poorly in N-staging of lymphadenopathy. At present, 18-F-desoxy-glucose positron emission tomography (FDG-PET) appears to be unreliable in the detection of RCC and its metastasis. This overview of current radiological and surgical literature attempts to describe how modern staging systems for RCC are organized, and which radiological and surgical developments currently influence the way in which primary staging and prognosis of RCC depend on one another.

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Section: Differentiation Of Tnm Classes T3b and T3cmentioning

confidence: 99%

Section: Differentiation Of Tnm Classes T3b and T3cmentioning

confidence: 99%

Staging of renal cell carcinoma

et al. 2007

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“…7,8 The level of clamping and adjuvant techniques depend on the degree of tumor propagation. 9 It could also be applied to other abdominal malignancies which had tumor thrombus in the IVC as experienced in case 7. In contrast, the site of direct invasion determines the level of IVC clamping in the retroperitoneal tumors.…”

Section: Discussionmentioning

confidence: 98%

Treatment of Abdominal Malignancy Invading the Vena Cava: A Report of Seven Cases

et al. 2007

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Retroperitoneal tumors and other abdominal malignancies invading the inferior vena cava can be treated surgically when no metastases are present. We resected four retroperitoneal tumors, two renal cell carcinomas, and one gastrointestinal stromal tumor with a concomitant caval resection. Although meticulous care is required when manipulating the major vessels, long-term survival with an improvement in the quality of life was achieved. These cases are described, with particular focus on the management of the major vessels.

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“…When the thrombus extends into the intrahepatic vena cava or above, mobilization of the liver with or without the use of cardiopulmonary bypass is required. The use of deep hypothermic cardiac arrest may also be required in some conditions [13][14][15][16] . Obviously, the morbidity and mortality rates of these operations are higher compared to the conventional radical nephrectomies.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management and Outcome of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus

Bérczi

Flaskó

Szerafin³

et al. 2017

Urol Int

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Introduction: The authors of this paper assessed the surgical management and outcome of renal cancers when tumor thrombus extended into the inferior vena cava (IVC). Methods: From 2000 to 2015, 46 radical nephrectomies were performed on patients with tumor thrombus in the IVC. The mean age of the patients was 60 ± 11 years. Radical nephrectomy and thrombectomies were performed in a single session. There were 18 level-IV, 23 level-III, and 5 level-II tumor thrombi. The operations were performed using cardiopulmonary bypass in 14 patients, while deep hypothermic cardiac arrest was carried out in 4 cases. Results: The mean size of the tumors was 9.4 ± 3.5 cm. Histology showed the tumor stages to be pT3b in 21cases, pT3c in 22, and pT4 in 3 patients. The mean follow-up period of the patients was 3.6 ± 3.0 years. During the follow-up period, local recurrence was observed in 7 patients, while distant metastases occurred in 8 cases. The median time to progression was 37 ± 27 months. The 5-year overall survival was 43.7%. Conclusions: Radical nephrectomy and thrombectomy provided reasonable long-term survival for patients with renal cancer and IVC thrombus. However, tumor progression was detected in 41.6%. The presence of tumor thrombus had a negative effect on tumor progression and survival.

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Renal Cell Carcinoma Associated with Tumor Thrombus in the Inferior Vena Cava: Surgical Strategies

Cited by 42 publications

References 29 publications

Staging of renal cell carcinoma

Staging of renal cell carcinoma

Treatment of Abdominal Malignancy Invading the Vena Cava: A Report of Seven Cases

Surgical Management and Outcome of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus

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