[Tumor involvement of the vena cava in renal cell carcinoma. Surgical technique, results and prognosis].

In 45 patients with a vena cava tumor thrombus secondary to renal cell carcinoma we present the diagnostic and operative management and relevant data on the extent of the thrombus (classified into 4 stages), postoperative complications and patient survival. Extensive thrombi of the vena cava were removed surgically in hypothermia and with extracorporeal circulation. The importance of an interdisciplinary approach involving cardiac and urologic surgeons is therefore emphasized. With due consideration for relevant prognostic parameters such as tumor differentiation or spread, we estimated a 5-year survival of 29% for our Heidelberg patients. Neither the extent of the tumor thrombus nor tumor infiltration of the perirenal adipose tissue had any influence on patient survival.