Giuliani L, Giberti C, Martorana G, Rovida S
Eur Urol. 1986;12(3):145-50. doi: 10.1159/000472603.
The results of the surgical management of 28 patients with renal cell carcinoma extending into the inferior vena cava have been analyzed. 8 patients had caval tumor thrombus extension at the level of the renal veins, 14 had infrahepatic, 5 retrohepatic and 1 atrial tumor thrombus extension. The caval wall was infiltrated by tumor in 7 cases. 9 patients had metastases. Lymph node involvement was seen in 9 patients. Life-table analysis of all 28 patients revealed on overall probability of survival of 32 and 9% at 2 and 5 years, respectively. The patients with caval involvement alone (N0M0) had a 2-year survival rate of 69%. Those with distant metastases or caval infiltration had a 2-year survival of 27 and 0% (p = NS). The level of caval tumor thrombus extension had a statistically insignificant influence on the survival of patients. In fact the 2-year survival rates of patients with caval thrombus at the level of the renal veins, below the large hepatic veins and above the large hepatic veins were 30, 36 and 32%, respectively. Our statistical data demonstrate that caval involvement has a very negative impact on the prognosis of patients with renal cancer.
对28例肾细胞癌侵犯下腔静脉患者的手术治疗结果进行了分析。8例患者的肿瘤血栓延伸至肾静脉水平，14例为肝下型，5例为肝后型，1例为心房型肿瘤血栓延伸。7例患者的下腔静脉壁被肿瘤浸润。9例患者发生转移。9例患者出现淋巴结受累。对所有28例患者进行生命表分析显示，2年和5年的总体生存率分别为32%和9%。单纯下腔静脉受累（N0M0）的患者2年生存率为69%。有远处转移或下腔静脉浸润的患者2年生存率分别为27%和0%（p=无显著性差异）。下腔静脉肿瘤血栓延伸水平对患者生存率的影响无统计学意义。事实上，肾静脉水平、肝大静脉以下和肝大静脉以上有下腔静脉血栓的患者2年生存率分别为30%、36%和32%。我们的统计数据表明，下腔静脉受累对肾癌患者的预后有非常负面的影响。
