Malignant renal tumor with extension to the inferior vena cava

Background: Management of malignant renal tumors involving the inferior vena cava (IVC) depends on tumor extension within the cava. Methods: Of 295 patients treated for renal cancer, propagation of tumor mass through the renal vein to IVC was seen in 22 (7%) patients. Cephalad extension of the tumor...

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Bibliographic Details
Published in:The American journal of surgery 1998-08, Vol.176 (2), p.137-139
Main Authors: Babu, Sateesh C., Mianoni, Tim, Shah, Pravin M., Goyal, Arun, Choudhury, Muhammad, Eshghi, Magid, Moggio, Richard A., Sarabu, Mohan R., Lafaro, Rocco J.
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
Adult
Aged
Atria
Biological and medical sciences
Blood clots
Carcinoid Tumor - pathology
Carcinoid Tumor - surgery
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - surgery
Carcinoma, Transitional Cell - pathology
Carcinoma, Transitional Cell - surgery
Catheters
Child
Child, Preschool
Contrast agents
Disease prevention
Dissection
Embolism
Embolisms
Female
Follow-Up Studies
Humans
Ischemia
Kidney - pathology
Kidney cancer
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Kidney Pelvis - pathology
Kidneys
Laparotomy
Magnetic resonance imaging
Male
Medical imaging
Medical sciences
Metastases
Metastasis
Middle Aged
Neoplasm Invasiveness
Neoplasms
Nephrectomy
Nephrology. Urinary tract diseases
Ostomy
Patients
Surgeons
Survival
Time Factors
Tumors
Tumors of the urinary system
Ultrasonic imaging
Vascular Neoplasms - pathology
Vascular Neoplasms - surgery
Veins & arteries
Vena Cava, Inferior - pathology
Vena Cava, Inferior - surgery
Wilms Tumor - pathology
Wilms Tumor - surgery
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Summary:Background: Management of malignant renal tumors involving the inferior vena cava (IVC) depends on tumor extension within the cava. Methods: Of 295 patients treated for renal cancer, propagation of tumor mass through the renal vein to IVC was seen in 22 (7%) patients. Cephalad extension of the tumor was suprarenal: infrahepatic in 12, retrohepatic in 6, and within the right atrium in 4 patients. All patients had radical nephrectomy, cavotomy, and complete resection of tumors except 1 with diffuse peritoneal metastasis. Results: Twenty-one patients had curative resections. No operative deaths and no instances of pulmonary embolism or exsanguination occurred. Seventeen patients were alive at 2 years and 12 at 5 years, resulting in 77% and 55% survival rates, respectively. Conclusions: An aggressive approach for vena cava involvement from malignant renal neoplasms resulted in prevention of tumor embolus, minimization of blood loss, and maintenance of venous return to the heart.
ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(98)00170-6