Up to 10% of patients with renal cell carcinoma (RCC) have locally advanced disease with venous tumour thrombosis involving the inferior vena cava (IVC). 30-50% of them present with synchronous metastatic disease. Surgical treatment remains the only potentially radical method for patients suffering from RCC and IVC tumour thrombosis without distant metastases. Five-year cancer-specific survival for such patients is 40-60%. The role of surgery in the treatment of RCC is significant, even if only cytoreductive operation is possible. Nephron-sparing surgery (NSS) is reasonably preferable for patients suffering from single kidney RCC, but it is not always radical enough. Extracorporeal approach allows to perform a radical dissection of the tumour in special complicated cases, but it is seldom used because of technical difficulties. We present a case of successful NSS by extracorporeal approach in our modification for RCC with IVC tumour thrombosis.
Case reports in oncology. 2020 Sep 29*** epublish ***
Tatiana Baitman, Irina Miroshkina, Alexander Gritskevich, Alexander Teplov, Andrey Zotikov, Alexander Kochetov, Valentina Demidova, Andrey Chupin, Yulia Stepanova, Wolfgang Schima, Grigory Karmazanovsky
Department of Urology, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., Department of Vascular Surgery, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., The Urology Center of A.A. Vishnevsky III Central Military Clinical Hospital, Moscow, Russian Federation., The Department of Laboratory Diagnostics, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., The Department of Ultrasound Diagnostics, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation., The Department of Diagnostic and Interventional Radiology, Göttlicher Heiland Krankenhaus, Barmherzige Schwestern Krankenhaus, and St. Josef Krankenhaus, Vinzenzgruppe, Vienna, Austria., The Department of Radiology, A.V. Vishnevsky National Medical Research Center of Surgery of the Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation.