title: [Experience with the of treatment renal cell carcinoma with thrombus in inferior vena cava and right atrium].
abstract: Retrospective analysis of definite staging and surgery results in 17 patients with renal cell tumour disseminated to lower cava vein who underwent radical nephrectomy and tumoral thrombectomy. Magnetic resonance predicted presence and level of tumoral thrombus in 100% and 88% cases, respectively. Neither venacavography or doppler echography provided additional information. Dissemination was infrahepatic in 9 (53%) cases, suprahepatic in 4 (24%) and to the right atrium in 4 (23%). Cardiopulmonary by-pass and hypothermic cardioplegia was used in 9 (53%) cases. Operative mortality and morbidity rates were 11% and 65%, respectively. The level of the thrombus did not significantly affect the prognosis which was highly affected however by regional node invasion. In all, CT and MRI can determine the extension and level of the cava vein thrombus in most cases. In our experience, disease-free survival is determined by the pathological stage and not by the extent of the cava thrombus. Radical nephrectomy and tumoral thrombectomy can provide long survival to patients with locoregional disease.
authors.affiliation: Division of Urology, St. Louis University School of Medicine, Missouri, USA.
authors.forename: O R
authors.initials: OR
authors.lastname: Parra
authors.forename: J
authors.initials: J
authors.lastname: Goméz Jimenez
authors.forename: P M
authors.initials: PM
authors.lastname: Gilson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D012189:Retrospective Studies; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D014682:Vena Cava, Inferior