Renal carcinoma extending into the inferior vena cava: vascular surgical aspects

Abstract

Objectives: To study surgical technique and results of treatment in patients receiving surgery for renal carcinoma or Wilm's tumour with extension into the vena cava. Methods: During the period 1993–98, altogether 15 patients received surgery. The investigation was retrospective. All patients were followed until death or at follow-up examination in December 2004. Results: A transverse laparotomy incision was used in 12 patients and a longitudinal incision in three. Two patients were primarily regarded as inoperable. Cardiopulmonary bypass was applied in one patient. At follow-up five patients were alive from 49 to 82 months postoperatively. The other 10 had died between two and 30 months after surgery, eight from carcinoma and two from other causes. Conclusion: In conclusion, involvement of the vena cava does not in itself indicate a dismal prognosis in patients with renal carcinoma. The tumour can usually be removed from the vena cava using exposure depending upon the extent of the tumour proximally into the vena cava.