Portal de Periódicos da CAPES

Carcinoma de células renales con extensión a vena cava: puesta al día y revisión de nuestra casuística

2009; Elsevier BV; Volume: 33; Issue: 5 Linguagem: Espanhol

10.1016/s0210-4806(09)74191-9

1699-7980

Fernando Vázquez Alonso, Francisco Javier Vicente Prados, José Manuel Cózar Olmo, Manrique Pascual Geler, Francisco J. Rodríguez Herrera, Antonio Martínez Morcillo, Eduardo Espejo Maldonado, Miguel Tallada Buñuel,

Vascular anomalies and interventions

To assess current management of renal cell carcinoma (RCC) extending into the inferior vena cava (IVC): staging, diagnosis, surgical approach, adjuvant therapy, prognostic factors and survival rate.Nineteen cases of RCC extending into the IVC undergoing surgical resection from January 1988 to August 2008 were reviewed. TNM staging and Neves-Zincke grading of the tumor were also assessed. Surgical approach depended on thrombus level.With a perioperative mortality rate of 10.5% and a mean follow-up of 22.65 months (range 2-79), 5 patients are still alive, while 11 patients died from the disease, 1 from an unrelated cause, and 2 were lost to follow-up. Patients with metastatic disease received adjuvant treatment with immunotherapy or kinase inhibitors. Mean survival was 15.1 months. Significant differences were found in 3- and 5-year survival rates in patients staged as N0M0 as compared to all other stages (N+M0, N0M+, N+M+). No differences were found depending on thrombus level.RCC with thrombus in the IVC is a tumor with a high mortality rate. Surgery continues to be the best option, and requires adequate preoperative evaluation and the support of an experienced and well trained multidisciplinary team. Survival depends on disease extension.