[Case series report of renal cell carcinoma with inferior vena cava involvement [surgery techniques and results in 8 patients]

ABSTRACT

Renal cell carcinoma can be presented with extension of thrombosis to renal vein and inferior vena cava. Management of these patients consists of radical nephrectomy and thrombectomy. In this study we reviewed approach to these patients. This is a case series report. During 1379 to 1384, 148 patients diagnosed with renal cell carcinoma [RCC] limited to Gerota's fascia [stage T3 or less] were admitted to Hasheminejad hospital. Fourteen patients had inferior vena cava [IVC] involvement. Radical nephrectomy as well as thrombectomy was performed in 8 patients. This investigation is done on these 8 patients. Patients' average age was 51.4 years. Six patients were male [75%] and 2 female [25%]. The most common symptoms were flank pain [75%], gross hematuria [62.5%] and structural symptoms [50%]. All patients had tumors limited to Gerota's fascia without any distant metastasis. Infrahepatic involvement of IVC was seen in 6 patients and in 2 patients thrombosis extended above the hepatic vein [infrahepatic]. No perioperative mortality was seen. Postoperative complications were atelectasia in 2 patients and deep vein thrombosis in one which was treated with conservative management. By skillful surgical approach in patients with RCC and IVC involvement, thrombosis can be completely excised without increasing the rate of complications and long term survival could be expected