CHSJ

Curr Health Sci J, vol. 47, no. 1, 2021

Outcomes in Renal Cell Carcinoma with Inferior Vena Cava Thrombus Treated with Surgery

[Original Paper]

S.I. Gamboa-Hoil(1), A. Martinez-Cornelio(1), N. Hernandez-Toriz(1), C. Riera-Kinkel(2)


(1)Oncology Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City,
(2)Cardiotoracic surgery, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México City


Abstract:

Introduction. Renal cell carcinoma can invade through the renal vein into the inferior vena cava, and can extend intraluminally, with tumor-thrombus formation. Methods: Retrospective study from January 2003 to August 2016. Surgical outcomes were analyzed. Neves classification was used for patient categorization. Kaplan Meier and Log-Rank test were used for survival analysis. Results: A total of 134 patients were included, 69 males (51.4%) and 65 females (49%), M:F ratio 1.06:1. Tumor size, bleeding and surgical time were higher in level IV thrombi (mean 16.1cm, 3 064ml and 6.5hrs, respectively), compared to level I (8.5cm, 1033ml and 3.1hrs, respectively). A higher frequency of positive lymph nodes was observed in levels III and IV compared with levels I and II (49% vs. 17.7%, p=0.0001). Distant metastases were observed in 36 pts. (27%). Overall surgical mortality was 4.5%. 5-year overall survival was 63%. We observed a 5-year survival in patients with level I-II 82% and level III and IV 46%. Conclusions: Our results suggest the benefit for the patient of an aggressive surgical approach with an acceptable mortality and 5-year survival rate. The results obtained justify an aggressive surgical approach to these tumors.


Keywords: Renal cancer, Thrombus, Inferior vena cava, Surgery, Urology.



Corresponding: Sergio Isidro Gamboa-Hoil, Oncology Hospital, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, e-mail: sergio_gamboa@hotmail.com


DOI 10.12865/CHSJ.47.01.15 - Download PDF
current issue cover Download cover
Download contents

Journal archive