title: Fifteen-year experience with renal cell carcinoma with associated venous tumor thrombus.
abstract: For patients with renal cell carcinoma with venous tumor thrombus (VTT), the importance of the extent of the VTT on survival has inconsistent published results. The aim of the study was to evaluate the prognostic value of the VTT on morbidity and mortality of our patients with renal cell carcinoma.
  
  
  
  This was a single institution review of all patients who underwent resection of renal cell carcinoma with VTT over a 15-year period.
  
  
  
  Thirty-seven patients (26 men, 11 women) with a mean age of 61 years were analyzed. The majority of the cohort were of Neves level II (n = 19), while 8 were of Neves 0 (only renal vein) or I, and 10 were of Neves III (extending into retrohepatic cava) or IV (extending supradiaphragmatically). When compared with Neves 0-II patients, there were more Neves III-IV patients with operative time >3 hours (70% vs 30%), blood loss >2,000 mL (70% vs 33%), and intensive care unit stay longer than one day (60% vs 30%) (P ≤ .05 each). Mean follow-up was 58 months. The overall 5-year survival was 71%, and all 10 patients with Neves III-IV had survived since the operation.
  
  
  
  We found advanced tumor thrombus involvement did not impact long-term survival; however, cases with suprahepatic VTT had increased operative time, blood loss, and duration of hospital stay.
authors: Division of Vascular Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors: Michael J
authors: MJ
authors: Nooromid
authors: Division of Vascular Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors: Mila H
authors: MH
authors: Ju
authors: Department of Surgery, University of Illinois at Chicago, Chicago, IL.
authors: George E
authors: GE
authors: Havelka
authors: Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors: James M
authors: JM
authors: Kozlowski
authors: Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, IL.
authors: Shilajit D
authors: SD
authors: Kundu
authors: Division of Vascular Surgery, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL. Electronic address: meskanda@nm.org.
authors: Mark K
authors: MK
authors: Eskandari
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009392:Nephrectomy / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000473:pathology