Ritchey M L, Kelalis P P, Breslow N, Offord K P, Shochat S J, D'Angio G J
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
J Urol. 1988 Nov;140(5 Pt 2):1113-8. doi: 10.1016/s0022-5347(17)41975-6.
We reviewed the records of 77 children enrolled in the National Wilms Tumor Study-3 who had involvement of the inferior vena cava with tumor thrombus. None of these patients received preoperative chemotherapy or radiotherapy. Ultrasonography and inferior venacavography were more helpful than computerized tomography in the preoperative diagnosis. The median followup for the group was 2.7 years. The 3-year survival rates for patients with intracaval involvement were determined by stage (88, 89 and 62 per cent for stages II, III and IV, respectively). The most important prognostic factor was histological type. The level of vena caval involvement had no effect on survival; all 16 patients with atrial involvement survived 3 or more years. We continue to recommend appropriate surgical excision of the tumor and thrombus when it is technically feasible.
我们回顾了参加国家肾母细胞瘤研究-3的77例患有下腔静脉肿瘤血栓的儿童的记录。这些患者均未接受术前化疗或放疗。术前诊断中，超声检查和下腔静脉造影比计算机断层扫描更有帮助。该组的中位随访时间为2.7年。腔静脉受累患者的3年生存率根据分期确定（II期、III期和IV期分别为88%、89%和62%）。最重要的预后因素是组织学类型。腔静脉受累程度对生存率无影响；所有16例心房受累患者均存活3年或更长时间。当技术可行时，我们继续建议对肿瘤和血栓进行适当的手术切除。
