[Surgical strategy in treatment of renal tumor complicated by tumor thrombosis in inferior vena cava].
BACKGROUND
In Denmark 650 renal cell carcinoma cases are diagnosed every year, and in 5-9% of the cases there is spread of the tumour in the form of tumour thrombosis in the inferior vena cava inferior.


OBJECTIVE
The purpose of this work is to describe the methods and outcome of operation regarding patients with such tumour thrombosis. According to the literature, the survival of these patients is not reduced provided there are no metastases to regional glands nor any distant metastases.


METHODS
We describe 13 cases operated in the urological ward at Rigshospitalet (the Danish national hospital) during a nine-year period.


RESULTS
In all 13 cases radical nephrectomy was performed and the tumour thrombus removed. In three cases the thrombus stretched into the right atrium, and the operations on these patients were performed in extra-corporal circulation. In one case the operation was performed in veno-venous bypass. There were two peri-operative deaths; one patient died during the operation from uncontrollable bleeding, the other on the ninth postoperative day. In both cases the thrombus stretched into the atrium. There were minor complications in three out of the remaining 11 cases, and in the last eight cases there were no complications. The two year survival was estimated at 50%.


CONCLUSIONS
On the basis the literature and our own results we recommend that patients with kidney tumour and tumour thrombus in the inferior vena cava are evaluated with a view to operation.
Lam
G W
GW
Thind
P O
PO
Sørensen
B L
BL
Efsen
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D011859:Radiography; D015996:Survival Rate; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery*; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*
Kirurgisk strategi ved behandling af nyretumor kompliceret med tumortrombe i vena cava inferior.