Al Otaibi Mohammed, Abou Youssif Tamer, Alkhaldi Abdulaziz, Sircar Kanishka, Kassouf Wassim, Aprikian Armen, Mulder David, Tanguay Simon
Department of Surgery, Division of Urology, McGill University Health Center, Montreal, Quebec, Canada.
BJU Int. 2009 Nov;104(10):1467-70. doi: 10.1111/j.1464-410X.2009.08575.x. Epub 2009 Apr 17.
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.
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.
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.
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.
评估我们对伴有下腔静脉（IVC）受累的肾细胞癌（RCC）进行手术切除的经验，并探讨预后与肿瘤范围之间的关系。
对1985年至2005年间进行的肾切除术进行回顾性研究，确定了50例肿瘤血栓延伸至下腔静脉的患者。评估了临床特征和预后。
在评估的50例患者中，分别有7例、26例、10例和7例出现I级、II级、III级和IV级血栓。16%的患者发生了主要术后并发症。25例（64%）患者出现局部或远处复发。复发的平均时间为10个月。只有肿瘤血栓的膈上延伸可预测疾病复发。
伴有下腔静脉血栓的局部晚期肾细胞癌仍然具有较高的局部和远处复发率。血栓延伸的程度与疾病复发显著相关。需要有效的辅助治疗来改善该患者群体的预后。
