Renal cell carcinoma: surgical management of regional lymph nodes and inferior vena-caval tumor thrombus.

Aggressive surgical management is the primary effective treatment of renal cell carcinoma, even with regional spread to lymph nodes or the vena cava. The extent of regional lymphadenectomy with radical nephrectomy and excision of vena-caval tumor thrombi are defined. In the future, with increasingly effective adjuvant therapy, these adjuncts to radical nephrectomy will continue to be important in the treatment of renal cell carcinoma.