[Outcome of surgical management of renal cell carcinoma with renal vein or inferior vena cava tumor thrombus].
OBJECTIVE
To investigate the prognosis of surgical treatment for renal cell carcinoma with renal vein or inferior vena cava tumor thrombus.


METHODS
Between August 1994 and July 2004, 33 patients with renal cell carcinoma with renal vein or inferior vena cava tumor thrombus underwent radical nephrectomy and thrombectomy. The study population included 26 male and 7 female. The median age was 60 years (20 - 82). Level of tumor thrombus was renal vein in 15 patients, infrahepatic (level I) in 9, intrahepatic (level II) in 5, suprahepatic (level III) in 1, and right atrial extension (level IV) in 3. Survival analysis was made with Kaplan-Meier method.


RESULTS
Twenty-nine patients can be followed up. Fourteen patients were lost with a mean survival time of (16.4 +/- 2.9) months (1 - 42 months). Fifteen patients were survival with a mean follow-up of (17.3 +/- 4.6) months (3 - 67 months). One patient was lost on the second postoperative day. Three patients can not be followed up. The 5-year Kaplan-Meier survival rate was 16%. The mean survival time of patients with renal vein involvement [(49.9 +/- 9.8) months] versus level I [(16.7 +/- 1.9) months] was significantly different (P < 0.05).


CONCLUSIONS
Radical nephrectomy plus thrombectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Patients with renal vein tumor thrombus appear to have better survival compared to patients with inferior vena cava tumor thrombus.
Song
Yi
Y
Department of Urology, First Hospital of Peking University, Institute of Urology, Peking University, Beijing 100034, China. ddsongyi@263.net
He
Zhi-song
ZS
Li
Ning-chen
NC
Li
Ming
M
Zhou
Li-qun
LQ
Na
Yan-qun
YQ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017128:Embolectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy / Q000379:methods*; D011379:Prognosis; D012082:Renal Veins / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*