PTU - Polskie Towarzystwo Urologiczne
list of articles:

Article published in Urologia Polska 1997/50/2.


Wojciech Stachowiak, Jean Pierre Fleury, Lionel Camillieri, Marek Jemielity, Paweł Kwinecki, Charles De Riberolles
Klinika Kardiochirurgii IK AM im. Karola Marcinkowskiego w Poznaniu
Kierownik: prof. dr hab. med. Aleksy Poniżyński
Klinika Chirurgii Sercowo-Naczyniowej Uniwersytetu w Clermont-Ferrand
Kierownik: prof. Charles de Riberolles


kidney renal cell carcinoma vena cava thrombus extracorporeal circulation


Objective. The paper reports the clinical results from 6 cases of renal cells carcinomas
with vena caval tumor thrombus.
Material and method. All the patients had tumor thrombus extension into the right
atrium. In all cases the patients underwent radical nephrectomy and vena caval
thrombectomy. Cardiopulmonary by-pass in normothermia was re±uired for transatrial
removal of all tumors.
Results. There were no operative deaths. Five of these 6 patients died from cerebral
or lung metastases from 4 to 7 months post-operatively (83,3%).
Conclusions. The presence of metastases in regional lymph nodes, perinephric fat
involvement and distant metastases seems to influence the survival rate. The techni±ues
now available for surgical resection of all levels of tumor thrombus of the inferior vena
cava make resection feasible in most patients.


  1. [1] Burt, }., Bowsher, W., Joyce, G., Peters, ]., Wood, A., White, A., Costello,
  2. A.: The menagement of renal cell carcinoma with inferior vena cava involvement
  3. Aust. N. Z. J. Surg., 1993, 63, 25-29.
  4. [2] Davits, R., Blom, }., Schroder, R: Surgical menagement of renal carcinoma with
  5. extensive involvement of the vena cava and right atrium. Br. J. Urol, 1992, 70,
  6. 591-593.
  7. [3] Goldfarb, D., Lorig, R., Zelch, M., Patrone, P., Bokowski, R., Pontes, J.:
  8. Right renal mass with vena caval thrombus. J. Urol., 1990,143, 574-577.
  9. [4] Hatcher, P. A., Anderson, E. E., Paulson, D. F., Carson, C. C, Robertson, J.
  10. E.: Surgical menagement and prognosis of renal cell carcinoma invading the vena
  11. cava. J. Urol., 1991,145, 20-24.
  12. [5] Jonosko, E., Powell, C, Spence, R, Hodges, W., Lust, R.: Surgical menagement
  13. of renal cell carcinoma with extensive intracaval involvement using a venous by-
  14. pass system suitable for rapid conversion to total cardiopulmonary by-pass }. Urol.
  15. 1991,145, 555-557.
  16. [6] Kearney, G. R, Waters, W. B., Klein, L. A., Richie, J. R, Gittes, R. R: Results
  17. of inferior vena cava resection for renal cell carcinoma. J. Urol., 1981,125, 769-773.
  18. [7] Marshall, V. R, Middleton, R. G., Holswade, G. R., Goldsmith, EL: Surgery
  19. for renal cell carcinoma in the vena cava. J. Urol., 1970,103, 414-420.
  20. [8] Montie, J. E., El Ammar, R., Pontes, J. E., Medendorp, S. V., Novick, A. C,
  21. Streem, S. B., Kay, R., Montague, D. K., Cosgrove, D. M.: Renal cell carcinoma
  22. with inferior vena cava tumor thrombi. Surg., Gynec. & Obst., 1991,173,107-115.
  23. [9] Nakayama, D., DeLormier, A., 0'Neill, }., Narkool, R, D'Angio, G.: Intra-
  24. cardiac Extension ofWilms'Tumor. Ann. Surg., 1984, 6, 693-698.
  25. [10] Ozono, S., Okajima, E., Tsukamoto, T., Kumamoto, Y., Nemoto, R., Uchida,
  26. K., Koiso, K., Kawamura, N., Akimoto, M., Kakehi, Y., Yoshida, O., Oami,
  27. M., Kotake, T.: Renal cell carcinoma extending into the vena cava: a multi-institu-
  28. te study. Jpn. J. Clin. Oncol., 1991, 21, 412-416.
  29. [11] Poussot, D., Ballanger, Ph.: Prognostic a long termę de cancers du rein avec
  30. thrombus cave. A propos de 30 cas Progres en Urologie. 1992, 2, 998-1005.
  31. [12] Pritchett, T., Raval, J., Benson, R., Lieskovsky, G., Coletti, R, Boswell, W.,
  32. Skinner, D.: Preoperative magnetic resonance imaging ofvena caval tumor throm-
  33. bi: experience with 5 cases J. Urol., 1987,138,1220-1223.
  34. [13] Ritchey, M., Kelalis, R, Breslow, N., Offord, K., Shoschat, S., D'Angio, G.:
  35. Intracaval and atrial involvement with nephroblastoma: reviev of national Wilms
  36. Tumor Study 3. J. Urol, 1988,140,1113-1118.
  37. [14] Roy, C, Spittler, G., Saussine, O, Kastler, B., Jac±min, D. Bourjat, R: Enva-
  38. hissement tumoral de la veina cave inferieure - Evaluation de I'echokardiographie,
  39. de la tomodensinometrie et de l'IRM. Rev. Im. Med., 1992, 4, 485-492.
  40. [15] Skinner, D., Pfister, R. F., Colvin, R.: Extension of renal cell carcinoma into the
  41. vena cava: the rationale for agressive surgical managment. J. Urol., 1972,107, 711-
  42. 716.
  43. [16] Skinner, D., Pritchett, T. R., Lieskovsky, G., Boyd, S. D., Stiles Q. R.: Vena
  44. caval involvement by renal cell carcinoma. Surgical resection prouides meaningful
  45. long term survival. Ann. Surg., 1989, 210, 387-394.
  46. [17] Suggs, W. D., Smith III, R. B., Dodson, T. R, Salam, A. A., Graham, Jr. S.
  47. D.: Renal cell carcinoma with inferior vana caval involvement. J. Vasc. Surg., 1991,
  48. 14, 413-418.
  49. [18] Szymanowski, ]., Czubak, M., KoĽmińska, E., Herlinger, G.: Własne do-
  50. ¶wiadczenie w chirurgii czopów nowotworowych układu żylnego u chorych na raka
  51. nerki Urol. Pol, 1995, 48, 53-6.
  52. [19] Tremeaux, J., Nabholtz, }., Brechet, E., Viard, H., Briet, S.: Cancer du rein et
  53. thrombus cave. Journal d'Urologie 1989,1, 61-73.
  54. [20] Vale, }., Hendry, W., Kirby, R., Whitfield, H., Lumley, S.: Diagnostic and
  55. surgical aspects of renal carcinoma with involvement of the inferior vena cava. Br. J.
  56. Urol. 1991, 68, 345-348.
  57. [21] Virdi, J. S., Kelly, D. G.: Prognostic value of renal venous involvement in renal
  58. carcinoma Br. J. Urol., 1992, 69, 481-495.