Professional paper
https://doi.org/10.20471/LO.2020.48.02-03.12
Multidisciplinary surgical treatment of clear-cell renal carcinoma with inferior vena cava tumor thrombus level III and IV: our experience during the past decade
Tvrtko Hudolin
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
Vladimir Ferenčak
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Luka Penezić
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Toni Zekulić
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Tomislav Kuliš
orcid.org/0000-0002-0895-5691
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
Marjan Marić
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Oliver Pavlović
; Faculty of Medicine, University Josip Juraj Strossmayer, Osijek, Croatia; Department of Urology, Osijek University Hospital Center, Osijek, Croatia
Ahmad El-Saleh
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia
Nikola Knežević
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
Eleonora Goluža
; University of Zagreb School of Medicine, Zagreb, Croatia; Department of Anesthesiology, Reanimatology, and Intensive Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Bojan Biočina
; Department of Cardiac Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia
Željko Kaštelan
; Department of Urology, University Hospital Center Zagreb, Zagreb, Croatia; University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
Patients with non-metastatic, stage T3 clear-cell renal cell cancer present a clinical challenge for urologists. The extent of tumor thrombus in inferior vena cava is the primary determinant of surgical procedure complexity. Level III and IV thrombi require the use of cardiopulmonary bypass and hypothermic arrest. Careful preoperative planning and a multidisciplinary approach are mandatory. In this paper, we report outcomes of 12 patients who were surgically treated in our center. The 29 months overall survival for all patients was 69%, while three patients died during follow-up. Of nine surviving patients, six are currently disease-free, whereas three had disease progression. Our study showed that carefully selected patients with clear-cell renal cell carcinoma with inferior vena cava tumor thrombus level III and IV could be successfully treated with an aggressive surgical approach.
Keywords
renal cell carcinoma; inferior vena cava; venous thrombosis; radical nephrectomy; cardiopulmonary bypass
Hrčak ID:
250344
URI
Publication date:
21.12.2020.
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