[Surgical management of renal cell carcinoma with vena cava-right atrium thrombus].
Historically the presence of a thrombus in vena cava was associated with worse prognosis in patients with renal cell carcinoma, and the effective of surgery limited. However a extensive tumor thrombi can be present without evidence of lymph node and distant metastasis, an aggressive surgical approach with curative intent is justified. We retrospectively reviewed 25 patients with renal cell carcinoma and thrombus in vena cava and they underwent radical nephrectomy and thrombectomy. The IRM allowed to know the level of the thrombus into vena cava in all patients: 56% level I, 8% level II, 26% level III. There were 14 pT3b, 8 pT3c, 3 pT4, and 48% N+. The rate of complications was 36% and there were 4 perioperative death (16%). Patients without lymph node and no distant metastasis had a mean survival of 64% 46%, 37% to 2, 3, 4 years respectively. Patients with lymph node invasive an distant metastasis the prognosis was poor. We no noted correlation between level thrombus and prognosis.
Ruibal Moldes
M
M
Servicio de Urología, Hospital Juan Canalejo, A Coruña.
Alvarez Castelo
L
L
Chantada Abal
V
V
Blanco Díez
A
A
Fernández Rosado
E
E
González Martín
M
M
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006325:Heart Atria / Q000473:pathology*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures; D014682:Vena Cava, Inferior / Q000473:pathology* / Q000601:surgery; D020246:Venous Thrombosis / Q000209:etiology / Q000473:pathology / Q000601:surgery*