scholarly journals Transabdominal two-cavity approach for radical nephrectomy combined with inferior vena cava thrombectomy for malignant thrombus caused by renal cell carcinoma: a case series

2018 ◽  
Vol 12 (1) ◽  
Author(s):  
R. Novotny ◽  
J. Chlupac ◽  
T. Marada ◽  
V. Borovicka ◽  
V. Vik ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Case Series

Inferior vena cava thrombus recurrence after radical nephrectomy in renal cell carcinoma.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 511-511
Author(s):  
Caroline Kauffmann ◽  
David A. Pfister ◽  
Daniel Porres ◽  
Axel Heidenreich
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Primary Therapy ◽  
The Mean

511 Background: Local recurrence after radical nephrectomy in renal cell carcinoma occurs in about 2-4% of the patients. An isolated intracaval thrombus is described in only very few cases. We report about our experience in the diagnosis and theapy of this random entity. Methods: 5 patients (2f, 3m) were referred to our institution with the diagnosis of an IVC thrombus recurrence. All patients had underwent a radical nephrectomy 1-9 years before the relapse. In 3 patients, the thrombus was diagnosed within the routine follow up, another 2 presented with swelling/deep vein thrombosis. The staging showed no other metastases. Results: The mean patient age at time of diagnosis was 73.8 (70-81) years. 2 patients presented with a level II thrombus, 2 with level III and one with a level IV thrombus. We could resect the thrombus completely in 4 cases and close the cava with a running suture. In one case we had to resect the inferior vena cava completely and replace it with a gortex prosthesis. The mean blood loss was 1.7 (0-8) liters at an operating time of 5.5 (4.3-7.6) hours. The mean follow up was 3.5 (0.5-8) years, until today occured one case of pulmonal metastatic disease. Significant perioperative complications classified after Clavien-Dindo occured in one case with an intraoperative bleeding and rupture oft he spleen that required a mass-transfusion. Conclusions: Although it is a technical demanding procedure, the surgical resection of a recurrent vena cava thrombus is the method of choice with only a little perioperative morbidity and high oncological effectivity. This random type of recurrent disease illustrates the importance of an adequate primary therapy as well as a regularly follow up after cava-involvement.

Resection of recurrent inferior vena cava tumor after radical nephrectomy for renal cell carcinoma

Urology ◽  
2006 ◽  
Vol 67 (5) ◽  
pp. 1084.e5-1084.e7 ◽  
Author(s):  
Marc C. Smaldone ◽  
Glenn M. Cannon ◽  
Ronald L. Hrebinko
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava

Perioperative and oncologic outcome in patients treated for renal cell carcinoma with an extended inferior vena cava tumour thrombus level II-IV

2019 ◽  
Author(s):  
Bernhard Ralla ◽  
Lisa Adams ◽  
Andreas Maxeiner ◽  
Josef Mang ◽  
Michael Krimphove ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Oncologic Outcome ◽  
Tumour Thrombus ◽  
Level Ii

Abstract Purpose Surgical treatment of patients with renal cell carcinoma (RCC) and an extended tumour thrombus (TT) in the inferior vena cava (IVC) is challenging and often requires a multidisciplinary approach. The aim of this study was to analyse results in the real-world management of RCC patients with an extended IVC TT (level II-IV according to the Mayo classification of macroscopic venous invasion in RCC) in terms of pre-, peri- and postoperative outcome, complications and oncologic outcome. Methods We investigated 61 patients with evidence of RCC and an extended TT in the IVC undergoing radical nephrectomy and tumour thrombectomy at our tertiary referral centre. Patients and operative characteristics were recorded and complications were analysed using the Clavien-Dindo classification. Follow-up data were retrieved by contacting the treating outpatient urologists, general practitioners and patients. Results The TT level was II in 36, III in 8 and IV in 17 patients. Complications grade IIIb and higher according to the Clavien-Dindo classification occurred in n = 3 (8.4 %), n = 2 (25.0 %) and n = 5 (29.5 %) patients with level II, III and IV TT, respectively. The overall survival of patients with TT level II, III and IV at 24 months (60 months) was 66.9 % (41.6 %), 83.3 % (83.3 %) and 64.1 % (51.3 %). Presence of primary metastatic disease was the only significant independent predictor for OS.  Conclusions Radical nephrectomy with tumour thrombectomy appears to be a feasible and effective treatment option in the management of patients with RCC and an extended IVC TT.

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