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Renal cell carcinoma with inferior vena caval extention: impact of tumour extent on surgical outcome
Author(s) -
Al Otaibi Mohammed,
Youssif Tamer Abou,
Alkhaldi Abdulaziz,
Sircar Kanishka,
Kassouf Wassim,
Aprikian Armen,
Mulder David,
Tanguay Simon
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08575.x
Subject(s) - medicine , renal cell carcinoma , nephrectomy , inferior vena cava , thrombus , surgery , radiology , carcinoma , kidney
OBJECTIVE To evaluate our experience with surgical resection of renal cell carcinoma (RCC) with inferior vena cava (IVC) involvement and examine the relationship between prognosis and tumour extent. PATIENTS AND METHODS A retrospective review of nephrectomy performed between 1985 and 2005 identified 50 patients presenting with tumour thrombus extension into the IVC. Clinical characteristics and outcome were evaluated. RESULTS Of the 50 patients evaluated, 7, 26, 10 and 7 presented with level I, II, III and IV thrombus, respectively. Major postoperative complications occurred in 16% of patients. Local or distant failure occurred in 25 (64%) patients. The mean time to recurrence was 10 months. Only supra‐diaphragmatic extension of the tumour thrombus was predictive of disease recurrence. CONCLUSION Locally advanced RCC with IVC thrombus remains associated with significant local and distant failure rate. The level of thrombus extension is significantly associated with disease recurrence. Effective adjuvant therapy is needed to improve outcome in this patient population.