Key result
IVC reconstruction during oncologic resection maintains ~88% primary patency at 3 years.
Why the study?
En bloc resection with IVC reconstruction is often required for retroperitoneal and solid organ tumors involving the IVC.
Cohort (n=80)
No
Surgical reconstruction of the inferior vena cava during oncologic resection is safe and durable, demonstrating high mid-term patency (87.7% at 3 years) and survival when performed at high-volume centers.
Supports consideration of IVC reconstruction at high-volume centers; extends prior observational data but leaves open need for prospective validation.
Background: En bloc resection with IVC reconstruction is often required for retroperitoneal and solid organ tumors involving the IVC. Techniques include direct repair, patch angioplasty, and interposition grafting. Methods: We conducted a retrospective review of all patients who underwent IVC reconstruction between January 2013 and June 2023 at a single tertiary center. Outcomes included reconstruction type, long-term patency, and survival. Results: Eighty patients (mean age 59 ± 15.9 years; 63.8% male) underwent IVC reconstruction: direct repair (38.8%), patch angioplasty (48.8%), and interposition graft (12.4%). Renal cell carcinoma (56.3%) and retroperitoneal sarcomas were the most common tumor types. Most tumors were high-grade (53.8%), with IVC involvement most frequently at the perirenal level (63.8%). Discharge antithrombotic regimens included aspirin (47.5%) and systemic anticoagulation (50%). Complete or severe thrombosis occurred in 12.5% of patients, largely due to local recurrence (50%) or early technical issues (40%). Kaplan-Meier estimated primary patency at 1, 2, and 3 years was 97.6%, 94.4%, and 87.7%, respectively. Thirty-day survival was 96.3%, with 1-, 2-, and 3-year survival rates of 86.5%, 76.8%, and 76.8%. Conclusions: IVC reconstruction during oncologic resection is safe and durable, with high mid-term patency and survival when performed at high-volume centers. Thrombosis is uncommon and often attributable to tumor recurrence or technical factors.
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Neves et al. (2026) conducted a cohort in Retroperitoneal and solid organ tumors involving the IVC (n=80). IVC reconstruction was evaluated on Reconstruction type, long-term patency, and survival. IVC reconstruction during oncologic resection demonstrated high durability, with Kaplan-Meier estimated primary patency of 87.7% and survival of 76.8% at 3 years.
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