Key result
Radical resection for renal cell caval thrombus yields ~10% mortality and 100% survivor patency.
Why the study?
Thrombotic involvement of the inferior vena cava occurs in about 10% of patients with renal cell carcinoma and is treated with radical resection, but further data on surgical outcomes are needed.
Does radical surgical resection improve venous patency and survival in patients with advanced renal cell carcinoma and retrohepatic IVC thrombus?
Does radical surgical resection improve venous patency and survival in patients with advanced renal cell carcinoma and retrohepatic IVC thrombus?
Radical surgical resection of retrohepatic IVC thrombus in advanced renal cell carcinoma can be performed safely and successfully with respect to venous patency.
Answers are grounded in this paper and cite their sources.
Surgical resection appears feasible for retrohepatic IVC thrombus in RCC; leaves open standardized protocols and long-term outcome validation.
BACKGROUND: Thrombotic involvement of the inferior vena cava (IVC) occurs in about 10% of all patients with renal cell carcinoma (RCC). It is treated with radical resection of tumor and thrombus. We present the results of a recent case series of 20 patients with retrohepatic IVC thrombus. METHODS: Our cohort of 20 patients included 16 primary resections (radical nephrectomy and thrombectomy with and without vascular graft), three recurrences primarily operated on elsewhere (thrombectomy and vascular graft), and one recurrence due to a new liver metastasis. RESULTS: All surviving patients were discharged with a patent IVC. The overall mortality rate was 10%, and the overall complication rate was 35%. Both are in keeping with results presented worldwide. CONCLUSIONS: Our series provides a corroborating extension to the existing dataset on RCC-related IVC thrombus removal. It confirms that the radical surgical approach can be performed safely and successfully with respect to venous patency.
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Polańska-Płachta et al. (2015) studied Advanced renal cell carcinoma with retrohepatic caval thrombus (n=20). Surgical thrombectomy was evaluated on Overall mortality rate. Surgical thrombectomy for retrohepatic caval thrombus in patients with advanced renal cell carcinoma resulted in a 10% overall mortality rate, a 35% complication rate, and 100% IVC patency among survivors.
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