Radical Nephrectomy and Pulmonary Lobectomy for Renal Cell Carcinoma With Tumor Thrombus Extension into the Inferior Vena Cava and Pulmonary Arteries

2020 ◽  
Vol 40 (10) ◽  
pp. 5837-5844
Author(s):  
AYSSWARYA MANOHARAN ◽  
ALEJANDRO LUGO-BARUQUI ◽  
GAETANO CIANCIO
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Pulmonary Arteries ◽  
Vena Cava ◽  
Pulmonary Lobectomy

scholarly journals Survival Benefits After Surgery of Renal Cell Carcinoma Patients with Inferior Vena Cava Thrombus

2021 ◽  
Author(s):  
Tawatchai Taweemonkongsap ◽  
Ekkarin Chotikawanich ◽  
Siros Jitpraphai ◽  
Varat Woranisarakul ◽  
Thitipat Hansomwong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Significant Difference ◽  
Ivc Thrombus

Abstract OBJECTIVE: To evaluate surgical and oncological outcomes after surgery in renal cell carcinoma (RCC) patients with inferior vena cava (IVC) tumor thrombus METHODS: A total of 58 patients from 2002 to 2019 underwent radical nephrectomy and IVC thrombectomy at Siriraj Hospital, Bangkok, Thailand, were retrospectively reviewed. Kaplan-Meier analysis was utilized to compare survival benefits between cohorts and Cox regression to evaluate predictors of patient survival. RESULTS: There were 5 (8.6%), 21 (36.2%), 23 (39.7%) and 9 (15.5%) patients with tumor thrombus level I, II, III and IV respectively. The major complications (Clavien 3-5) were observed in 15 patients (25.8%) and 80% were patients with high thrombus level (III-IV). There was 9% mortality (5 patients): 2 intraoperatively and 3 postoperatively. Median follow-up was 15 months (IQR:5-41). Two-year overall survival (OS) was 80% and 75% in all patients and pN0M0 cohort, respectively. There was significant difference in OS among each IVC thrombus level cohort (p<0.02). Two-year OS of metastatic RCC patients was 67% and not significantly different when compared to non-metastatic cohort (p=0.12). On multivariate analysis, only sarcomatoid dedifferentiation was associated with OS (p=0.04). Disease-free survival was not significantly different among thrombus-level cohorts (p=0.65). CONCLUSION: Our study suggested that surgical treatment for RCC with IVC thrombus provided acceptable OS outcomes, even in a small volume experience. Although the survival was significantly reduced with higher IVC thrombus level cohort, the level of thrombus itself was not an independent factor. Only sarcomatoid dedifferentiation was a predictor for OS after radical nephrectomy and tumor thrombectomy.

scholarly journals Sonographic Evaluation of Inferior Vena Cava Tumor Thrombus in Renal Cell Carcinoma: A Case Study of a Rare Condition

2018 ◽  
Vol 34 (5) ◽  
pp. 375-382
Author(s):  
Viyana Hamblen
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Wilms Tumor ◽  
Circulatory Arrest ◽  
Vena Cava ◽  
Ivc Tumor

Inferior vena cava (IVC) tumor thrombus in renal cell carcinoma is a rare entity that suggests heightened biologic behavior and a surgical challenge during the course of treatment. Tumor thrombus can extend from the renal vein to the right atrium. This cephalad extension is classified by four different levels. These levels determine which surgical approach is used, whether a thoracoabdominal incision is needed, and whether a patient needs to be placed in circulatory arrest. Complete surgical resection of the tumor is potentially the only curative treatment, although it supposes a challenge because of operative difficulty and the potential for massive bleeding or tumor pulmonary thromboembolism. IVC tumor thrombus presents with a few differentials that need to be assessed, including bland thrombus, primary IVC leiomyosarcoma, hepatocellular carcinoma, adrenal cortical carcinoma, primary lung carcinoma, and Wilms tumor. The importance of diagnosing IVC tumor thrombus secondary to renal cell carcinoma is demonstrated as well as a sonographic protocol for assessing IVC tumor thrombus.

scholarly journals Role of presurgical targeted molecular therapy in renal cell carcinoma with an inferior vena cava tumor thrombus

2018 ◽  
Vol Volume 11 ◽  
pp. 1997-2005 ◽  
Author(s):  
Cheng Peng ◽  
Liangyou Gu ◽  
Lei Wang ◽  
Qingbo Huang ◽  
Baojun Wang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Molecular Therapy ◽  
Targeted Molecular Therapy
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