Robotic Surgery for Renal Cell Carcinoma with Vena Caval Tumor Thrombus

Abaza, Ronney; Eun, Daniel; Gallucci, Michele; Gill, Inderbir S.; Menon, Mani; Mottrie, Alexandre; Shabsigh, Ahmad

doi:10.1016/j.euf.2017.01.001

Cited by 36 publications

(23 citation statements)

References 33 publications

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“…In the current cohort, open procedures were performed, with laparotomy being the most common approach. Some authors have reported laparoscopic techniques or even robotic ones to be feasible in these cases [23,28]. Furthermore, we did not observe any influence of the hospital reference on patients' survival.…”

Section: Discussionsupporting

confidence: 42%

Analysis of Clinicopathological Factors Influencing Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus

Zapała

Sharma

Kunc

et al. 2021

JCM

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This study aimed to define patients with renal cell cancer and coexisting tumor thrombus in order to address concerns regarding survival and prognostic factors after radical surgery. Several prognostic factors for overall survival (OS) were assessed in patients treated surgically at five institutions from 2012 to 2018. Univariate and multivariate analyses were used to determine the independent risk factors of OS. A total of 142 patients were eligible for further analysis (mean age of 64.75 years, 56% males). Most patients presented with clear cell carcinoma (95%). The Mayo stage was predominantly 0–1 (88%). Distant visceral metastases at the time of diagnosis were present in 36 patients (25%), whereas nodal metastases were present in 24 patients (16.9%). During the follow-up period (mean of 32.5 months), the 3-year OS rate reached 68.2%. The majority of patients received no adjuvant treatment (n = 107). In a multivariable model predicting OS, regional lymph node status (p < 0.001), distant metastases (p = 0.009), tumor grade (p = 0.002), duration of hospitalization (p = 0.016), and Clavien–Dindo grade (p = 0.047) were identified as independent prognostic factors. A subgroup of patients with specific clinicopathological factors may benefit most from the radical surgery, including patients without regional lymph node or distant metastases and with low tumor grades, whereas short hospitalization and low Clavien–Dindo grades represent additional independent prognostic factors.

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Section: Discussionsupporting

confidence: 42%

Analysis of Clinicopathological Factors Influencing Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus

Zapała

Sharma

Kunc

et al. 2021

JCM

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“…However, more recent reports have demonstrated the feasibility and safety of robotic‐assisted laparoscopic approaches to extracting more advanced IVC tumor thrombi associated with RCC, including up to level 3 tumor thrombi, via mobilization of the intrahepatic IVC below the main hepatic vein for cross‐clamping . Since this initial report in 2015, more papers have been published, including a multi‐institutional study, which confirm that a robotic approach may be a reasonable option potentially associated with less morbidity …”

Section: Preoperative Imaging As Guidance For Operative Planningmentioning

confidence: 76%

“…32 Since this initial report in 2015, more papers have been published, including a multi-institutional study, which confirm that a robotic approach may be a reasonable option potentially associated with less morbidity. 33…”

Section: Distinguishing Between Level 3 and Level 4 Tumor Thrombi Is mentioning

confidence: 99%

The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

et al. 2018

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We reviewed the role of transesophageal echocardiography (TEE) in the management of renal cell carcinoma (RCC) with associated tumor thrombus. Many consider intraoperative TEE as imperative in cases of Level 4 thrombi with atrial involvement, as well as in cases that require the use of cardiopulmonary bypass (CPB). However, the role of TEE in the surgical management of RCC with associated inferior vena cava (IVC) thrombus may expand beyond this subset. When performed after induction, TEE provides updated information regarding tumor thrombus staging, which is essential for optimal surgical planning. Furthermore, TEE provides feedback regarding properties of the thrombus, such as fragility and adherence, which may alter surgical technique. TEE can also be used intraoperatively for central venous line placement, to monitor cardiovascular and fluid status, to guide vascular clamp placement, and to ensure complete removal of the tumor thrombus. In some cases, the use of TEE allows for less morbid procedures and safe avoidance of CPB. We therefore recommend the use of preoperative TEE in all cases with a known tumor thrombus with discretion as to what extent TEE is used throughout the remainder of the case. Further investigation is necessary to elucidate the effect of TEE on patient outcomes, including surgical complication rates, morbidity and mortality of procedures, and cancer control.

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“…Since Abaza's report, a number of other series have been described in the literature, including cases of level III thrombi . A multi‐institutional retrospective review examined 32 patients who underwent surgery with nine different surgeons at nine different institutions .…”

Section: Robotic Radical Nephrectomy and Inferior Vena Cava (Ivc) Thrmentioning

confidence: 99%

“…A systematic review of nine series examined a total of 99 patients who underwent robotic nephrectomy with level II or level III thrombectomy ; each series had between 1 and 32 patients. The mean length of hospital stay ranged from 1.2 to 5.8 days, and the complication rate ranged from 6% to 25%.…”

Section: Robotic Radical Nephrectomy and Inferior Vena Cava (Ivc) Thrmentioning

confidence: 99%

Recent advancements of robotic surgery for kidney cancer

Phung

Lee

2018

Asian J Endoscop Surgery

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Surgical management of renal cell carcinoma has undergone a transformation in recent decades, especially with the dissemination of the robotic platform. Increasingly, larger and more complex renal lesions are now being treated in a minimally invasive fashion. The purpose of this article is to review advances in the use of the robotic approach for treatment of renal cell carcinoma, including nephron-sparing surgery, radical nephrectomy, and cytoreductive nephrectomy.

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Robotic Surgery for Renal Cell Carcinoma with Vena Caval Tumor Thrombus

Cited by 36 publications

References 33 publications

Analysis of Clinicopathological Factors Influencing Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus

Analysis of Clinicopathological Factors Influencing Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus

The role of transesophageal echocardiography in the management of renal cell carcinoma with venous tumor thrombus

Recent advancements of robotic surgery for kidney cancer

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