title: Resection of the inferior vena cava for urological malignancies: single-center experience.
abstract: BACKGROUND
  Resection of the inferior vena cava (IVC) is occasionally performed for patients with advanced malignancy in the retroperitoneum. In the current study, we assessed the oncological effectiveness of IVC resection combined with tumor resection. We also addressed peri- and postoperative complications associated with resection and reconstruction of the IVC.
  
  
  METHODS
  Between 1984 and 2011, a total of 23 patients underwent caval resection concurrently with retroperitoneal tumor excision. Primary tumor histology was renal cell carcinoma in 19 patients, metastatic germ cell tumor in 2, and leiomyosarcoma, and adrenal cancer in 1 patient each. Clinicopathological data from these patients were retrospectively reviewed.
  
  
  RESULTS
  IVC reconstruction was performed by direct suture in 11 patients, patch repair in 8 and graft replacement in 3 patients. Interruption of the IVC was performed in one patient. There was no lethal complication or pulmonary embolism. Intracaval thrombosis, although patent, was observed in four patients after surgery. All patients underwent infrarenal IVC reconstruction. The median follow-up was 12 months (range 1-121 months). Of the 20 patients without distant metastasis at the time of surgery, complete resection was achieved in 14, whereas 6 patients had positive margins. Although nine patients developed distant metastases postoperatively, there was no local recurrence. The overall survival, progression-free survival and cause-specific survival in those RCC patients without distant metastasis at the time of surgery were 56.1, 47.0 and 60.4%, respectively, at 5 years.
  
  
  CONCLUSIONS
  For advanced malignancies involving the IVC, resection is a safe and feasible procedure for selected patients.
authors.affiliation: Department of Urology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kato
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.forename: Toshiro
authors.initials: T
authors.lastname: Ito
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Kawaharada
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D011183:Postoperative Complications / Q000145:classification / Q000473:pathology; D012186:Retroperitoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*