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October 16, 2018Journal of Medical Case ReportsOpen Access

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

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Key result

Transabdominal radical nephrectomy combined with inferior vena cava thrombectomy resulted in no postoperative mortalities or recurrences in three patients over an average 23-month follow-up.

Why the study?

Does transabdominal radical nephrectomy combined with inferior vena cava thrombectomy improve outcomes in patients with renal cell carcinoma and malignant intravascular thrombus?

Population

3 white Caucasian women diagnosed with renal cell carcinoma and malignant intravascular thrombus requiring…

Design

Case_series

Follow-up

average 23 months (range 2-48 months)

Authors

RNRóbert NovotnýNHS Blood and TransplantJCJaroslav ChlupáčCharles UniversityTMTomáš MaradaInstitute of Clinical and Experimental Medicine

Discussion

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Implication

Supports feasibility of combined nephrectomy and IVC thrombectomy in select RCC cases; leaves open need for larger studies on outcomes and selection.

Study Design

Type

Case Report (n=3)

Multicenter

No

Structured PICO

Does transabdominal radical nephrectomy combined with inferior vena cava thrombectomy improve outcomes in patients with renal cell carcinoma and malignant intravascular thrombus?

P
Population
3 women (mean age 67 years) with advanced renal cell carcinoma and malignant intravascular thrombus who underwent radical nephrectomy combined with inferior vena cava thrombectomy.
I
Intervention
Radical nephrectomy combined with inferior vena cava thrombectomy through a transabdominal two-cavity approach (using transesophageal echocardiogram guidance for supradiaphragmatic cross-clamp placement).
O
Outcome
Postoperative mortality and recurrence of inferior vena cava malignant intravascular thrombushard clinical

A transabdominal two-cavity approach for radical nephrectomy combined with inferior vena cava thrombectomy is feasible and provides good mid-term oncological outcomes without the need for sternotomy.

Limitations

  • Very small sample size of only three patients
  • Lack of a control group
  • Short follow-up duration for some patients (as short as 2 months)

Cite This Study

Novotný et al. (2018) conducted a case report in Renal cell carcinoma with malignant intravascular thrombus (n=3). Transabdominal two-cavity approach for radical nephrectomy combined with inferior vena cava thrombectomy was evaluated on Postoperative mortality and recurrence of inferior vena cava malignant intravascular thrombus. Transabdominal radical nephrectomy combined with inferior vena cava thrombectomy resulted in no postoperative mortalities or recurrences in three patients over an average 23-month follow-up.

synapsesocial.com/papers/6a8719eca6ddb97d43d3d072https://doi.org/10.1186/s13256-018-1845-2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic Outcomes and Risk Factors for Patients with Renal Cell Carcinoma and Venous Tumor Thrombus after Radical Nephrectomy and Thrombectomy: The Prognostic Significance of Venous Tumor Thrombus Level2015 · 27 citations
  2. 2Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival2016 · 34 citations
  3. 3Cardiovascular Evaluation before Circulatory Arrest for Removal of Vena Caval Extension of Renal Carcinoma1989 · 24 citations
  4. 4Impact of Synchronous Metastasis Distribution on Cancer Specific Survival in Renal Cell Carcinoma after Radical Nephrectomy with Tumor Thrombectomy2014 · 39 citations
  5. 5Venous tumor thrombus consistency is not predictive of survival in patients with renal cell carcinoma: A retrospective study of 147 patients2015 · 16 citations