The impact of extracorporal circulation on therapy-related mortality and long-term survival of patients with renal cell cancer and intracaval neoplastic extension

Kuczyk, Markus A.; Münch, T.; Machtens, S.; Grünewald, V.; Jonas, Udo

doi:10.1007/s00345-002-0286-z

Cited by 18 publications

(11 citation statements)

References 10 publications

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“…At the same time, recent advances in cross‐sectional imaging have led to a more precise delineation of what are not infrequently massive primary tumours, and have improved the ability to detect the extent of the VTT, thereby aiding the planning of the optimal management approach. Also, improved support before and during surgery now allows more patients to be considered for aggressive surgery [11,12]. At our centre, the above factors have led to a gradual increase over time in the number of patients treated surgically for RCC with IVC VTT.…”

Section: Introductionmentioning

confidence: 99%

Renal cell carcinoma: vena caval involvement

2007

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Section: Introductionmentioning

confidence: 99%

Renal cell carcinoma: vena caval involvement

2007

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“…Non‐metastatic tumors are potentially curable provided complete removal of cancerous tissue can be achieved. The presence of intracaval tumor extension does not affect any independent prognostic value in cases of RCC, 8 whereas previous investigations have suggested that cephalad extent of tumor thrombus exerts a substantial impact on clinical prognosis 5 . In addition, dissection of tumor thrombus extending into the right atrium reportedly results in significant therapy‐related mortality 5 .…”

Section: Discussionmentioning

confidence: 85%

“…In addition, dissection of tumor thrombus extending into the right atrium reportedly results in significant therapy‐related mortality 5 . However, the lower frequency of peri‐ and postoperative complications and improved long‐term survival following extracorporeal circulation have been reported 8,9 . Some reports advocate the use of cardiopulmonary bypass to facilitate removal of tumor thrombus, particularly tumor thrombus extending into the right atrium 10,11 .…”

Section: Discussionmentioning

confidence: 99%

Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium

et al. 2006

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Aim:The application of cardiopulmonary bypass to atrial involvement represents an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking. Our experiences of the management of extended thrombi into the right atrium in patients with retroperitoneal malignancy using a cardiopulmonary bypass were discussed. Methods: Data were reviewed for five patients (two men and three women; mean age, 60.4 years; range, 49-79 years) with retroperitoneal tumors displaying intracardiac tumor extension. Tumors originated in the right kidney in four patients, and in left adrenal gland in one patient. Cardiopulmonary bypass was used in all cases. Results: Mean total blood loss was 6059 mL. Mean operative time was 14.7 h. No intra-or postoperative complications due to surgical technique were encountered, and no significant bleeding occurred during incision of the inferior vena cava or after removal of tumor thrombus. The follow-up period ranged from 3 to 20 months with a mean of 12.6 months. Of the five patients, three died of metastatic diseases, one died of liver dysfunction and one remains disease free as of 18 months postoperatively. Conclusions: Our experience indicates that this procedure can be safely used for atrial involvement. Although superior long-term survival cannot be shown yet, favorable early results and a lack of perioperative complications were identified.

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“…Similarly, Kuczyk et al. 55 pointed to lymph node metastasis (5‐year survival rate, 7.8%) and distant metastasis (5‐year survival rate, 7.4%) as poor prognostic factors (2a).…”

Section: Clinical Practice Guidelines For Managing Rccmentioning

confidence: 95%

Evidence‐based clinical practice guidelines for renal cell carcinoma (Summary – JUA 2007 Edition)

Fujioka

Obara

2009

Int J of Urology

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The text of these guidelines was published for general clinicians, general urologists, and patients, with the aim of providing a system of effective and efficient clinical practices for managing renal cell carcinoma based on evidence-based medicine-intended techniques. The guidelines contain the answers to a total of 21 clinical questions (CQ) that were formulated under the headings of 'risk factors and prophylaxis,''diagnosis,''surgical treatment and local treatment,' and 'systemic treatment,' along with the recommendation grades and systems/algorithms for clinical practice based on structured abstracts prepared through critical reviews of the relevant published reports; the literature search was conducted using the key words for each CQ. An abridged edition of these guidelines can be found on the web pages of the Japan Society of Clinical Oncology and the Medical Information Network Distribution Service.

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The impact of extracorporal circulation on therapy-related mortality and long-term survival of patients with renal cell cancer and intracaval neoplastic extension

Cited by 18 publications

References 10 publications

Renal cell carcinoma: vena caval involvement

Renal cell carcinoma: vena caval involvement

Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium

Evidence‐based clinical practice guidelines for renal cell carcinoma (Summary – JUA 2007 Edition)

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