title: 18-year recurrence-free survival after extensive surgery for kidney cancer with atrial tumor thrombi.
abstract: Tumor thrombus formation is a unique aspect of renal cell carcinoma with significant therapeutic and prognostic implications. The prognostic significance of cephalad extent of tumor thrombi to the right atrium remains controversial. Extended surgical removal, however, is the only way to expect survival. In 1989, a 40-year-old man was diagnosed with an advanced renal cell carcinoma (T(3C)N(2)M(0)) involving perinephric fat, hilar and para-aortic lymph nodes and a tumor thrombus extending to the right atrium. He was treated with extensive surgical resection of the tumor and its lymphatic and vascular extensions. Interferon-alpha injections were given for 2.5 years as an adjuvant immunotherapy. The patient was annually checked with abdominal ultrasound, chest X-ray and computed tomography, but has manifested no local or distant metastasis for 18 years. To our knowledge, this is the first reported case of extensive surgery on advanced renal cell carcinoma with no evidence of recurrence for 18 years.
authors: Department of Urology, Kagawa University, Faculty of Medicine, Kagawa, Japan.
authors: Mohammed Ahmed Abdel-Muneem
authors: MA
authors: Nouh
authors: Masashi
authors: M
authors: Inui
authors: Mikio
authors: M
authors: Sugimoto
authors: Yoshiyuki
authors: Y
authors: Kakehi
authors: Akihiro
authors: A
authors: Yasukawa
mesh_terms: D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D017741:Survivors; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery