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[Inferior vena cava thromboses in renal cancers. 20 years' experience]
Annales D'Urologie
|January 1, 1985
Summary
This review indicates a poor prognosis for cancer invading the vena cava, even with surgery. Careful patient selection is crucial due to likely microscopic metastases.
Area of Science:
- Oncology
- Surgical Oncology
- Vascular Surgery
Context:
- Review of a personal series evaluating caval thrombus extent, lymph node involvement, surgical treatment, and survival.
- Contrasts findings with previous optimistic reports, highlighting a generally poor prognosis.
- Addresses advanced cancer with vena cava invasion and potential for distant microscopic metastases.
Purpose:
- To evaluate the prognosis and surgical outcomes for cancers involving the vena cava.
- To identify critical factors influencing survival and treatment decisions.
- To recommend optimal surgical techniques for specific thrombus locations.
Summary:
- Cancer invasion of the vena cava is associated with a poor prognosis due to the high likelihood of pre-existing distant microscopic metastases.
- Effective chemotherapy is lacking, thus surgical intervention should be reserved for carefully selected patients with good general health and no signs of metastasis or lymph node involvement.
- Cardiopulmonary bypass is recommended as the safest technique for managing supradiaphragmatic thrombus.
Impact:
- Informs clinical decision-making for advanced cancers involving the vena cava.
- Emphasizes the importance of thorough patient selection for surgical candidates.
- Highlights the role of cardiopulmonary bypass in improving safety for specific surgical scenarios.