SURGICAL MANAGEMENT OF THE RENAL CANCER WITH THE TUMOR THROMBUS IN THE VENOUS SYSTEM T3B AND T3C
Authors:
P. Morávek; J. Dominik; P. Habal; P. Navrátil; J. Pacovsky; P. Žáček
Authors‘ workplace:
FN a LF UK Hradec Králové
; Urologická klinika
Published in:
Urol List 2011; 9(4): 30-37
Overview
Surgical management of the renal cancer with the tumor thrombus in the venous system T3b and T3c represents exacting surgical procedure. Removing of the thrombus of the II and III level and especially level IV in the right heart atrium, is always associated with high risk of the peroperative and late complications. Indication to the surgery covers excluding organ and lymphatic metastases and good performance status. The most critical phase of the surgery is the securing the thrombus and its protection against its spontaneous tearing away with fatal consequences. The tumor thrombus extraction (level II to IV) is from the radicality and safety term suitable only in case of interdisciplinary collaboration of the urologist with the thoracic surgeon or the cardio surgeon.
Key words:
renal cell carcinoma, tumor thrombus, surgical management
Sources
1. Morávek P. Nádory ledvin. In: Dvořáček J, Babjuk M et al. Onkourologie. 2005 Praha Galén 2005 a Karolinum: 31–44.
2. Ficarra F, Righetti R, D’Amico A. Renal vein and vena cava involvement does not affect prognosis in patiens with renal cell carcinoma. Oncolgy 2001; 61(1): 10–15.
3. Hatcher PA, Anderson EE, Paulson DF et al. Surgical management and prognosis of renal cell carcinoma invading the vena cava. J Urol 1991; 145(1): 20–24.
4. Morávek P, Dominik J. Radikale Operation wegen eines Nierenkarzinoms mit einer tumorthrombose im rechten Herzvorhof. Journal für Urologie und Gnynäkologie 2002; 9(4): 20–25.
5. Nevees RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol 1987; 59(5): 390–395.
6. Skinner DG, Pritchett TR, Lieskovski G et al. Vena cava involvement be renal cell carcinoma: surgical resection provides meaningful long- term survival. Ann Surg 1989; 210(3): 387–392.
7. Sosa RE, Muecke EC, Vaughan ED et al. Renal cell carcinoma extending into the IVC: the prognostic significance of the level of IVC involvement. J Urol 1984; 132(6): 1097–1100.
8. Tsuji Y, Goto A, Hara I. Renal cell carcinoma with extension of tumor thrombus into the vena Cava: surgical strategy and prognosis. J Vasc Surg 2001; 33(4): 789–796.
9. Giuliani L, Gibert C, Martorana G et al. Radical extensive surgery for renal cell carcinoma: long- term results and prognostic factors. J Urol 1990; 143(3): 468–473.
10. Nesbitt JC, Soltero ER, Dinney CP et al. Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus. Ann Thorac Surg 1997; 63(6): 1952–1600.
11. Zini L, Haulon S, Decoene C et al. Renal cell carcinoma associated with tumor trombus in the inferior vena cava: Surgical strategies Ann Vasc Surg 2005; 19(4): 522–528.
12. Baše J, Navrátil P, Navrátilová J et al. Tumorous thrombosis of the inferior vena cava: Authors experience with surgical treatment. Rozhl Chir 1993; 72: 303–306.
13. Bissada NK, Yakout HH, Babanouri A et al. Long-term experience with management of renal cell carcinoma involving the inferior vena cava. Urology 2003; 61(1): 89–92.
14. Hinnman F. Atlas urologischer Operationen Herausgeber der deutschen Augabe Herbert Ruben und Jens Altwein 1994, Ferdinand Enke Verlag Stuttgart.
15. Hohenfellner R, Fichtner J, Stein R. Ausgewahlte urologische Op- Technikem,step-by-step. 2. überarbeitete und erweitere Auflage 1997: Georg Thieme Verlag Stuttgart-New York.
16. Morávek P, Navrátil P Jr., Habal P et al. Chirurgická léčba karcinomu ledviny s nádorovým trombem v žilním řečišti hladiny III. Urológia 2006; 4: 18–23.
17. Ciancio G, Vaida A, Savoie M et al. Management of renal cell carcinoma with level III trombus in the inferior vena cava. J Urol 2002; 168 (4 Pt 1): 1374–1377.
18. Ciancio G, Soloway M. Resection of the abdominal inferior vena cava for complicated renal cell carcinoma with tumour trombus. BJU international 2005; 96(6): 815–818.
19. Ciancio G, Soloway M. Renal cell carcinoma with tumor trombus extending above diaphragm: Avoiding cardiopulmonary bypass. Urology 2005; 66(2): 266–270.
20. Ciancio G, Hawke C, Soloway M. The use of liver transplant techniques to aim in the surgical management of urological tumors. J Urol 2000; 164 (3 Pt 1): 665–672.
21. Reissig A, Janetschek G, Eberle J et al. Renal cell carcinoma extending into the vena cava: surgical approach, technique and results. Br J Urol 1995; 75(2): 138–142.
22. Voght P, Esner R, Pretre R et al. Lessinvasive surgical treatment of renal cell carcinomas extending into the right heart and pulmonary arteries. Surgery of renal cell carcinoma, J Card Surg 1999; 14(5): 330–333.
23. Janosko EO, Powel CS, Spence PA et al. Surgical management of renal cell casrcinoma with extensive intracaval involvement using a venous bypass systém suitable for rapid conversion to total cardiopulmonary bypass. J Urol 1991; 145(3): 555–557.
24. Hashiba T, Hirokawa M, Chiba K et al. Treatment of renal cell karcinoma extending into right atrium with extra-corporeal circulation using high grade hypothermia: acase report. Hinyokika Kiyo 2000; 46(4): 255–259.
25. Klein EA, Kaye MC, Novick AC. Management of renal cell carcinoma with vena caval tumor thrombi via cardiopulmonary bypass and deep hypothermic circulatory arrest. Urol Clin North Am 1991; 18(3): 445–447.
26. Novick AC, Kaye M, Pontes JE et al. Experience with cardiopulmonary bypass and deep hypothermic circulatory arrest in the management of retroperitoneal tumors with vena caval thrombi. Ann Surg 1990; 212(4): 472–476.
27. Ochi T, Tanji N, Shimamoto K et al. Application of cardiopulmonary bypass ror resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atrium. Int J Urol 2006; 13(3): 202–205.
28. Yamashita CH, Azami T, Okada M et al. Usefulness of cardiopulmoary vypase in reconstruction of inferior vena cava occupied by renal cell carcinoma tumor trombus. Angiology 1999; 50(1): 47–53.
29. Glazer A, Novick AC. Long -term follow-up after surgical treatment for renal cell carcinoma extending into the right atrium. J Urol 1996; 155(2): 448–450.
30. Kalaycioglu S, Sinci V, Aydin H et al. Cardiopulmonary vypase technique for treatment of renal cell carcinoma extending into the vena. Ann Thorac Cardiovasc Surg 1999; 5(6): 419–422.
31. Ciancio G, Soloway M. The use of natural veno-venous bypass during surgical treatment of renal cell carcinoma with inferior vena cava thrombus. Am Surg 2002; 68(5): 488–490.
32. Obadia JF, Clavel JP, Bonnefoy E. Surgery of cavoatrial extension of renal malignant tumors using a veno-venous shunt. Br J Urol 1997; 80(5): 812–814.
33. Morávek P, Dominik J, Navrátil P et al. Surgery of renal carcinoma with tumour thrombosis involving the right atrium. Rozhl Chir 1996; 75(12): 603–606.
34. Morávek P, Dominik J. Chirurgická léčba karcinomu ledviny s nádorovým trombem v pravé srdeční síni. Výsledky léčby (1993–2005). Klin Urol 2006; 2(3): 139–145.
35. Svenson LG, Crawford ES, Hess KR. Deep hypothermia with circulatory arrest: determinant of stroke and early mortality in 656 patients. J Thorac Cardiovasc Surg 1993; 106(1): 19–28.
36. Ruel M, Bedard P, Morash CR. Resection of right atriall tumor thrombi without circulatory arrest. Ann Rhorac Surg 2001; 71(2): 733–734.
37. Singhal R, Vricella LA, Mitchel RS et al. Cavoatrial tumor trombus excision without circulatory arrest. Urology 2003; 62(1): 138–140.
38. Stewart JR, Carey JA, McDougal WS et al. Cavoatrial tumor thrombectomy using cardiopulmonary bypass without circulatory arrest. Ann Thorac Surg 1991; 51(5): 717–721.
39. Cervinka WH, Ciancio G, Salerno TA et al. Renal cell cancer with invasive atrial tumor trombus excised off-pump. Urology 2005; 66(6): 1319.
40. Bassi P, Del Moro F, Ciaccia M et al. Transdiaphragmatic-intrapericardiac approach to supradiaphragmatic vena cava invasion secondary to renal cell carcinoma: a novel surgical approach. Urology 2005; 66(5): 1101–1105.
Labels
Paediatric urologist UrologyArticle was published in
Urological Journal
2011 Issue 4
Most read in this issue
- PROSTATE CANCER PREDICTION BASED ON PCA3 EVALUATION
- RENAL CANCER EARLY DETECTION, THE ROLE OF TUMOUR MARKERS IN FURTHER DIAGNOSTIC, THERAPEUTIC AND PROGNOSTIC STRATEGY
- SURGICAL MANAGEMENT OF THE RENAL CANCER WITH THE TUMOR THROMBUS IN THE VENOUS SYSTEM T3B AND T3C
- LAPAROSCOPIC AND ROBOTIC HEMINEPHRECTOMY AND URETEROURETEROSTOMY FOR DUPLEX COLLECTING SYSTEM OF UPPER URINARY TRACT