The influence of perinephric fat involvement on survival in patients with renal cell carcinoma extending into the inferior vena cava.

Records of patients with renal cell carcinoma extending into the inferior vena cava were reviewed. Patients with nodal metastases or distal spread were excluded, leaving 19 cases available for analysis. The over-all 3 and 5-year survival rates were 56 and 38 per cent, respectively, but a striking difference in survival was observed when those patients with perinephric fat involvement (T3ac) were separated from those whose tumours had not penetrated through the renal capsule (T3c). The 3 and 5-year survival rates for patients with T3ac tumors were 14 and 0 per cent, compared to 82 and 67 per cent for patients with T3c tumors. Patients with T3ac tumors had metastases earlier (mean 13 months) than patients with T3c tumors (mean 22 months). The over-all mean survival duration was 50 months. However, the mean survival duration of patients with T3ac tumors was 17 months, compared to 75 months for patients with T3c tumors.