title: [Rational diagnosis and surgical therapy of renal cell carcinoma with tumor thrombosis in the vena cava].
abstract: Venous involvement in renal cell carcinoma (RCC) represents an advanced state of disease. Nonetheless, its influence on survival is rather secondary compared with that of local tumor growth, grading and metastasis. Since conservative treatment in advanced RCC is mainly ineffective, surgical management offers the most promising approach for potential cure. Only patients without metastasis, however, seem to benefit from an aggressive surgical intervention. The surgical technique itself is determined by the vena caval extent of the tumor thrombus. Preferably, noninvasive imaging techniques should provide information about metastasis and the extent of the tumor thrombus. Diagnostic efforts should be adapted to therapeutic feasibility and prognosis in every individual patient in order to avoid fatiguing and costly over-examination. The standards requested above can be realized by use of modern sonographic and computed-tomographic imaging techniques or by magnetic resonance imaging alone. Thus, nowadays, the essential diagnostics in RCC with vena caval involvement may dispense with angiographic examinations.
authors.affiliation: Urologische Universitätsklinik Münster.
authors.forename: H J
authors.initials: HJ
authors.lastname: Piechota
authors.forename: K
authors.initials: K
authors.lastname: Wörtler
authors.forename: H
authors.initials: H
authors.lastname: van Ahlen
authors.lastname: St Roth
authors.forename: R
authors.initials: R
authors.lastname: Soeparwata
authors.forename: L
authors.initials: L
authors.lastname: Hertle
mesh_terms: D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D011379:Prognosis; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery