Baitman Tatiana, Miroshkina Irina, Gritskevich Alexander, Teplov Alexander, Zotikov Andrey, Kochetov Alexander, Demidova Valentina, Chupin Andrey, Stepanova Yulia, Schima Wolfgang, Karmazanovsky Grigory
Department of Urology, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.
Department of Vascular Surgery, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.
Case Rep Oncol. 2020 Sep 29;13(3):1202-1208. doi: 10.1159/000510404. eCollection 2020 Sep-Dec.
Up to 10% of patients with renal cell carcinoma (RCC) have locally advanced disease with venous tumour thrombosis involving the inferior vena cava (IVC). 30-50% of them present with synchronous metastatic disease. Surgical treatment remains the only potentially radical method for patients suffering from RCC and IVC tumour thrombosis without distant metastases. Five-year cancer-specific survival for such patients is 40-60%. The role of surgery in the treatment of RCC is significant, even if only cytoreductive operation is possible. Nephron-sparing surgery (NSS) is reasonably preferable for patients suffering from single kidney RCC, but it is not always radical enough. Extracorporeal approach allows to perform a radical dissection of the tumour in special complicated cases, but it is seldom used because of technical difficulties. We present a case of successful NSS by extracorporeal approach in our modification for RCC with IVC tumour thrombosis.
高达10%的肾细胞癌（RCC）患者存在局部晚期疾病，伴有累及下腔静脉（IVC）的静脉肿瘤血栓形成。其中30 - 50%的患者同时出现转移性疾病。对于患有RCC和IVC肿瘤血栓形成且无远处转移的患者，手术治疗仍然是唯一可能的根治性方法。此类患者的五年癌症特异性生存率为40 - 60%。手术在RCC治疗中的作用显著，即使只能进行减瘤手术。对于单肾RCC患者，保留肾单位手术（NSS）是较为合理的首选，但它并不总是足够根治性。体外途径允许在特殊复杂病例中对肿瘤进行根治性切除，但由于技术困难很少使用。我们展示了一例通过体外途径成功进行NSS的病例，这是我们针对伴有IVC肿瘤血栓形成的RCC进行改良后的方法。
