[Vena cava invasion in kidney carcinoma--a typical example of multidisciplinary surgery]

Between 1987 and 1998, a total of 79 patients with renal cell carcinoma and venal caval thrombus underwent radical nephrectomy with removal of the tumor thrombus. Of these patients, nine had atrial thrombus extension. Actuarial 5 year survival for patients without metastasis was 39%. For patients with tumor thrombi not invading the right atrium (state I-III) the 5 year survival rate was up to 50% and was not related to the cranial extent of the tumor thrombus. We conclude that an aggressive multispeciality surgical approach is justified as it provides prolonged survival even in patients with large vena caval thrombi.