Surgical Management of Renal Cell Carcinoma with Vena Cava Tumor Thrombus

Publisher Website
Google Scholar
Abstract
The results of the surgical management of 28 patients with renal cell carcinoma extending into the inferior vena cava have been analyzed. 8 patients had cavai tumor thrombus extension at the level of the renal veins, 14 had infrahepatic, 5 retrohepatic and 1 atrial tumor thrombus extension. The cavai wall was infiltrated by tumor in 7 cases. 9 patients had métastasés. Lymph node involvement was seen in 9 patients. Life-table analysis of all 28 patients revealed on overall probability of survival of 32 and 9% at 2 and 5 years, respectively. The patients with cavai involvement alone (N0M0) had a 2-year survival rate of 69%. Those with distant métastasés or cavai infiltration had a 2-year survival of 27 and 0% (p = NS). The level of cavai tumor thrombus extension had a statistically insignificant influence on the survival of patients. In fact the 2-year survival rates of patients with cavai thrombus at the level of the renal veins, below the large hepatic veins and above the large hepatic veins were 30, 36 and 32%, respectively. Our statistical data demonstrate that cavai involvement has a very negative impact on the prognosis of patients with renal cancer.