Fifteen-year experience in radical nephrectomy with inferior vena cava tumor thrombectomy for patients with locally advanced and metastatic renal cell carcinoma

Abstract

Objective: To investigate the clinical out-comes and complications of radicalnephrectomy with inferior vena cava(IVC) tumor thrombectomy for patientswith locally advanced or metastatic renalcell carcinoma (RCC).Patients and Methods: All patientsunderwent radical nephrectomy with IVCtumor thrombectomy from 2001 to 2016were reviewed.Results: 29 patients (male: female: 20:9)with mean age of 66 (48–85) were reviewed.10 patients had metastatic disease (8 withlung metastases and 2 with bone metastases)preoperatively. Level I to IV IVC tumorthrombus were found in 5(17%), 7 (24%), 12(41%) and 5(17%) patients respectively. Themedian follow-up was 61.2 months (1–162).The mean blood loss for level I to IV tumorthrombus was 1,566 mL, 2,040 mL,2,503 mL and 6,340 mL respectively. Threepatients (10.3%) had Clavien-Dindo Grade 3complications. Six patients (60%) with meta-static disease received adjuvant targetedtherapy. There was no 30-day mortality. Thefive-year overall survival rates for localisedand metastatic RCC were 70% and 56%respectively. Five-year recurrence free sur-vival for locally advanced disease was 45%.Conclusion: Radical nephrectomy withIVC tumor thrombectomy provided satis-factory survival outcomes for patients withlocally advanced and metastatic RCC.