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Vena caval involvement with renal tumors: surgical considerations
C G Tribble1, T M Gerkin, T L Flanagan
1University of Virginia Medical Center, Department of Surgery, Charlottesville 22908.
The Annals of Thoracic Surgery
|July 1, 1988
Summary
Aggressively resecting renal tumors involving the inferior vena cava (IVC) is recommended. Complete tumor removal offers survival benefits, with acceptable risks and no need for dialysis, despite higher complication rates.
Area of Science:
- Urology
- Surgical Oncology
- Nephrology
Background:
- Renal tumors can invade the inferior vena cava (IVC), posing surgical challenges.
- Understanding outcomes for patients with IVC involvement is crucial for treatment planning.
Purpose of the Study:
- To review the University of Virginia's 10-year experience with renal tumors involving the IVC.
- To compare outcomes between patients with and without IVC tumor involvement.
- To describe the operative approach for these complex cases.
Main Methods:
- Retrospective review of 107 patients with renal tumors over 10 years.
- Analysis of 18 patients with confirmed IVC involvement.
- Comparison of complication rates and survival between groups.
Main Results:
- 18 of 107 patients had IVC involvement; 41 had renal vein invasion.
- Operations on the IVC had higher complication rates but were not fatal and did not require chronic dialysis.
- Life-table analysis showed improved survival for patients with complete IVC tumor resection.
Conclusions:
- Surgical resection of renal tumors involving the IVC is feasible with acceptable morbidity and mortality.
- Complete resection of IVC tumors is associated with a survival advantage.
- Given the ineffectiveness of chemotherapy and radiation, aggressive surgical management is recommended.