Results of the operative treatment of the renal cancer with the neoplasmatic thrombus involving VCI
Article published in Urologia Polska 2006/59/3.

authors

Jerzy Polański ¹, Maciej Czaplicki ², Ewa Koźmińska ², Paweł Szalecki ², Andrzej Borkowski ²: ¹ II Katedra i Klinika Chirurgii Ogólnej, Naczynowej i Onkologicznej II WL AM w Warszawie
² Katedra i Klinika Urologii Akademii Medycznej w Warszawie

keywords

kidney, renal cancer, neoplasmatic thrombus in the vena cava inferior (VCI), operative treatment, results

summary

Objectives. The aim of the study was to evaluate the results of the operative treatment of patients suffering from the renal cancer with the neoplasmatic thrombus involving VCI.

Materials and methods. 1650 patients with renal cancer underwent operation. In 61 cases thrombus in the lumen of VCI was found, in 53 of them kidney with thrombus were removed, in 7 of them, only kidney was removed, in one patient laparatomy without the removal of the kidney was performed, because of the extension of the disease. Minor neoplasmatic thrombi were removed in 13 patients, infrahepatic thrombi were removed in 25 patients, hepatic thrombi in 11 patients. Among the group of 11 patients with thrombus ending in hearth atrium, thrombectomy was done in 4 cases, in one patient operation was performed with use of extracorporeal circulation and hypothermia. The entire thrombus was removed in all patients, resection of the VCI wall, was performed in 8 cases.

Results. There was no death during the operative procedures, perioperative complications occurred in 21 patients. Postoperative complications were observed in 21 patients. Follow-up ranged from 1.5 to 189 months. Perioperative mortality was 8.3%. 7 patients died during the first 12 months of observation. Nearly 50% of patients with stage pT3b N0M0, who underwent operation, survived over 4 years.

Conclusions. In the examined collection of data there are no clear points of concentration of higher incidence of deaths, therefore it can be assumed that, after the perioperative period and after surviving the first year, the survival is rather linked to other circumstances than neoplasmatic disease.

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