期刊
UROLOGIA INTERNATIONALIS
卷 99, 期 3, 页码 267-271出版社
KARGER
DOI: 10.1159/000464108
关键词
Renal cancer; Tumor thrombus; Inferior vena cava; Thrombus level
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. (C) 2017 S. Karger AG, Basel
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