The elaboration of new operative procedures established in the last decade has led to an improved prognosis in patients with renal cell carcinoma with vena caval extension. We report on our personal operative experience in over 100 patients and present the current analysis of 76 patients with renal carcinoma with vena caval extension seen in our institution between 1985 and 1996. Sixty-six patients underwent nephrectomy and removal of vena caval tumor thrombi. Actuarial 5-year survival for patients without metastasis was 38%. For patients with tumor stages between I and III, 5-year survival was between 40 and 50% and was not significantly related to the rostral extent of the tumor thrombus. The relatively poor outcome for patients with tumor thrombi invading the right atrium was caused by a high perioperative mortality (50%). For patients with distant metastases, medium survival time was 10.5 months, implying that radical surgery is useless in cases of distant metastases.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s001200050075 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Resection and Reconstruction of the Inferior Vena Cava Using a Tunneled Peritoneal Graft for Renal Tumor With Thrombus: Venous Compensation via the Azygos Vein Following Early Graft Occlusion.
Cureus
December 2024
Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma De Nuevo León, Monterrey, MEX.
Inferior vena cava (IVC) invasion by tumor thrombus poses a significant surgical challenge, often requiring vascular reconstruction. Standard methods, including prosthetic and autologous vein grafts, have limitations such as infection risks, anticoagulation demands, and increased costs. We present the case of a 66-year-old male with a right renal tumor (T3bN0M0, Neves Zincke II) and gross hematuria, who underwent radical nephrectomy with open thrombectomy.
View Article and Find Full Text PDFRight atrial metastasis after renal cell carcinoma operation: a case report.
AME Case Rep
January 2025
Department of Oncology, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Background: Treatment options for patients with high-risk metastatic clear cell renal cell carcinoma (mccRCC) include immune checkpoint inhibitors and tyrosine kinase inhibitors (TKIs), but clinical manifestations and treatment of these patients are rarely reported because patients with cardiac metastases and abrupt circulatory disorders are very rare and there are no precise guidelines to follow. In this study, we analyzed and discussed the clinical characteristics, related characteristics, pathogenesis and treatment strategies of patients with cardiac metastases of kidney cancer, so as to provide reference for the diagnosis and treatment of cardiac metastatic tumors.
Case Description: The patient was diagnosed with renal cell carcinoma and underwent surgical radical resection, no special treatment was performed after surgery.
Successful Radical Resection Of Masaoka Iii Squamous Cell Thymic Carcinoma Invading Superior Vena Cava And Right Atrium - Case Report.
Port J Card Thorac Vasc Surg
January 2025
Thoracic Surgery Department, Pulido Valente Hospital, CHULN, Lisbon, Portugal.
Introduction: Complete radical resection is crucial for successfully treating thymic carcinomas. However, when the invasion of the great vessels or the heart in Masaoka III and IV stages occurs, the management poses more challenges. The R0 resection often requires neoadjuvant treatment.
View Article and Find Full Text PDFPosterior Hepatectomy and Inferior Vena Cava Graft Reconstruction for En Bloc Resection of a Hepatocellular Carcinoma: A Tribute to Couinaud's Liver Anatomy Description.
Ann Surg Oncol
January 2025
Department of Hepatobiliary and Digestive Surgery, Pontchaillou University Hospital, Rennes, France.
Background: Hepatocellular carcinoma (HCC) associated with major vasculature tumor extension is considered an advanced stage of disease to which palliative radiotherapy or chemotherapy is proposed. Surgical resection associated with chemotherapy or chemoembolization could be an opportunity to improve overall survival and recurrence-free survival in selected cases in a high-volume hepatobiliary center. Moreover, it has been 25 years since Couinaud described the entity of a posterior liver located behind an axial plane crossing the portal bifurcation.
View Article and Find Full Text PDFEndovascular Downstaging: A New Method for Managing Renal Cell Carcinoma Tumor Thrombus Invading the Inferior Vena Cava Above the Hepatic Veins (Level III) or into the Heart (Level IV).
Cancers (Basel)
January 2025
Department of Urology, Tufts University Medical Center, 800 Washington St., Boston, MA 02111, USA.
Background: Renal cell carcinoma tends to invade venous structures, frequently extending beyond the inferior vena cava and into the heart itself, such as into the right atrium or right ventricle. Resection of tumor burden, particularly tumor thrombus, often requires cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA), which is not feasible for all patients.
Methods: Described in this study is a novel, minimally invasive endovascular approach involving endovascular thrombectomy as a viable approach in these select patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!