Surgical Management of
Retroperitoneal Tumors with Vena
Cavai Thrombus in the Inferior Cava
Using Cardiopulmonary Bypass,
Arrested Circulation and Profound
Hypothermia

Rodriguez-Rubio, F.I.; Abad, J.I.; Sanz, G.; Diez-Caballero, F.; Martin-Marquina, A.; Rosell, D.; Robles, J.E.; Zudaire, J.J. (a); Lorens, R.; Beriàn, J.M.

doi:10.1159/000480858

Cited by 12 publications

(4 citation statements)

References 11 publications

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“…Note that 43 documented papers (Table S1) reported paediatric patients with Wilms tumour and intravascular extension, with age in the range of 7 weeks‐16 years. Sample size ranged from 1 to 165 patients.…”

Section: Resultsmentioning

confidence: 99%

Optimal neoadjuvant chemotherapy duration in Wilms tumour with intravascular thrombus: A literature review and evidence from SIOP WT 2001 trial

Morris

Squire

Sznajder

et al. 2019

Pediatric Blood & Cancer

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Introduction:Preoperative chemotherapy is recommended for children with Wilms tumour with intravascular extension. Extended chemotherapy may improve resectability, but increase tumour adherence to vascular endothelium, precluding complete resection. To evaluate the optimal length of preoperative treatment, we report a two-part review comprising systematic review of the literature and investigation of patients treated in the International Society of Paediatric Oncology (SIOP) WT 2001 trial. Methods: Studies were identified using Medline and Embase databases from 1996 to present. English language titles reporting management of intravascular Wilms tumour were analysed. Patients with Wilms tumour and thrombus were identified from the SIOP WT 2001 trial. Overall survival (OS) and event-free survival (EFS), tumour regression, completeness of resection and cavectomy were investigated. Results: The search retrieved 43 articles documenting 498 children. Note that 72% of the patients received neoadjuvant chemotherapy: 101 received standard course (4-6 weeks, standard course neoadjuvant chemotherapy [StC]) and 62 extended course (> 6 weeks, extended course neoadjuvant chemotherapy [EC]). There was no significant difference between the groups in terms of thrombus regression or completeness of resection. EFS was greater in the StC group (78 vs 54%; P = .04). Of 4511 patients registered in the SIOP WT 2001 trial, 166 had thrombus. Note that 97% of the patients received neoadjuvant chemotherapy: 63 StC and 67 EC. There was no significant difference between the groups with regard to tumour regression, complete resection, or cavectomy. Survival was significantly higher in those receiving StC than EC (OS: 95% vs 82%, P = .025; EFS: 88% vs 72%, P = .047). Conclusion:There is no evidence that prolonged courses of neoadjuvant chemotherapy beyond the recommended protocols confer any additional benefit in treating intravascular extension of Wilms tumour.

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Section: Resultsmentioning

confidence: 99%

Optimal neoadjuvant chemotherapy duration in Wilms tumour with intravascular thrombus: A literature review and evidence from SIOP WT 2001 trial

Morris

Squire

Sznajder

et al. 2019

Pediatric Blood & Cancer

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“…El paro circulatorio, la circulación extracorpórea y la hipotermia profunda para la extracción del trombo intracavo se han comunicado previamente para otros tumores con extensión retroperitoneal, aparte de las neoplasias testiculares pri-mitivas 6 . Rodríguez-Rubio et al 16 comunicaron supervivencia a largo plazo en pacientes con rabdomiosarcoma paratesticular tras este tratamiento.…”

Section: Comentariounclassified

“…En este último grupo destacan la linfadenectomía retroperitoneal y la resección de un trombo tumoral en la vena cava 4,5 . Aunque la presencia de un trombo tumoral en la vena cava inferior rara vez se asocia con los tumores testiculares, exige tratamiento quirúrgico para aumentar las probabilidades de curación y supervivencia del paciente 6 .…”

Section: Introductionunclassified

Tratamiento quirúrgico de un tumor testicular retroperitoneal metastásico con trombo en la vena cava inferior mediante derivación cardiopulmonar, paro circulatorio e hipotermia profunda: un caso clínico

et al. 2009

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Los tumores testiculares son el tipo más frecuente de neoplasia sólida en los varones de 18 a 35 años de edad. Su tasa de curación aproximada es del 90% 1,2. En algunos casos puede producirse invasión vascular del tumor, que exigirá resección quirúrgica para detener la progresión de la enfermedad y prevenir episodios tromboembólicos. La cirugía es la única opción terapéutica válida, aunque el procedimiento entraña un riesgo elevado. Presentamos el caso clínico de un paciente sometido con éxito a quimioterapia y cirugía por un tumor del testículo derecho asociado con un trombo tumoral en la vena cava inferior que se extendía desde la vena renal a la aurícula derecha y linfadenopatía retroperitoneal extensa.

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“…Early diagnosis and surgical treatment are essential for renal cell carcinoma, which has the highest mortality rate amongst urological cancers. [1][2][3] Even though the localization of a thrombus has been determined by preoperative evaluations, there may be migration from the thrombus, and small or large ruptures may occur by the time of operation. 4 The aim of this case report is to highlight the importance of intraoperative transesophageal echocardiography (TEE) in a patient with renal cell carcinoma, which showed unexpected tumor thrombi in the right atrium, and changed the surgical plan.…”

Section: Introductionmentioning

confidence: 99%

Thrombi migration to atrium diagnosed by transesophageal echocardiography

Erdemli

Demir

Güçlü

et al. 2013

Asian Cardiovasc Thorac Ann

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Two days before surgery in a 70-year-old man with renal cell carcinoma, transthoracic echocardiography showed a dense mass in the inferior vena cava, lying proximally, but no mass was observed in the right atrium. Intraoperative transesophageal echocardiography revealed unexpected tumor thrombi in the right atrium, and the surgical plan was changed. This case highlights the importance of intraoperative transesophageal echocardiography in patients with renal cell carcinoma.

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Surgical Management of Retroperitoneal Tumors with Vena Cavai Thrombus in the Inferior Cava Using Cardiopulmonary Bypass, Arrested Circulation and Profound Hypothermia

Cited by 12 publications

References 11 publications

Optimal neoadjuvant chemotherapy duration in Wilms tumour with intravascular thrombus: A literature review and evidence from SIOP WT 2001 trial

Optimal neoadjuvant chemotherapy duration in Wilms tumour with intravascular thrombus: A literature review and evidence from SIOP WT 2001 trial

Tratamiento quirúrgico de un tumor testicular retroperitoneal metastásico con trombo en la vena cava inferior mediante derivación cardiopulmonar, paro circulatorio e hipotermia profunda: un caso clínico

Thrombi migration to atrium diagnosed by transesophageal echocardiography

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