title: Surgical outcome following radical nephrectomy in cases with inferior vena cava tumour thrombus extension.
abstract: OBJECTIVE
  To report our experience with extensive surgery in patients with and without metastatic renal cell carcinoma and gross venous tumour thrombus.
  
  
  METHODS
  Twenty-seven patients with unilateral renal cell carcinoma and tumour thrombus into the vena cava underwent radical nephrectomy and thrombectomy. Eight patients presented with metastatic disease at the time of surgery. Mean follow-up was 17 months (1-54 months, median 9 months). Follow-up was available for 26 patients (96%).
  
  
  RESULTS
  Thirteen patients were alive at the time of the study; 11 without evidence of disease with a mean follow-up of 25 months and two (one with and one without metastasis at surgery) with distant metastasis at 16 and 36 months. Eleven patients have died of progressive disease. Mean survival in patients (19 patients) without metastatic disease at time of surgery was 15.2 months; patients (seven patients) with metastatic disease at surgery had a mean survival of 6.7 months.
  
  
  CONCLUSIONS
  Radical nephrectomy and vena caval tumour thrombectomy can be performed in selected patients with an acceptable complication rate. Patients without metastatic disease have a better prognosis than patients with metastatic disease.
authors.affiliation: Klinik und Poliklinik für Urologie, Universitätsklinikum Bonn, Rheinische Friedrich-Wilhelms Universität, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. patrick-bastian@ukb.uni-bonn.de
authors.forename: P J
authors.initials: PJ
authors.lastname: Bastian
authors.forename: A
authors.initials: A
authors.lastname: Haferkamp
authors.forename: I
authors.initials: I
authors.lastname: Akbarov
authors.forename: P
authors.initials: P
authors.lastname: Albers
authors.forename: S C
authors.initials: SC
authors.lastname: Müller
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D015996:Survival Rate; D017131:Thrombectomy; D013927:Thrombosis / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D014682:Vena Cava, Inferior