Surgery in Patients with Renal Cell Carcinoma and Tumor Thrombus of Inferior Vena Cava

Chervyakov Yu.V.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0001-5270-9968

Komlev D.L.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0003-4180-5326

Staroverov I.N.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0001-9855-9467

Lonchakova O.M.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0003-4507-6693

Pamputis S.N.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0002-7880-1081

Zavyalov D.V.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0002-9173-6878

Baranov G.A.

Russian University of Medicine

ORCID: 0000-0003-1394-4185

Surgery in Patients with Renal Cell Carcinoma and Tumor Thrombus of Inferior Vena Cava

Authors:

Chervyakov Yu.V., Komlev D.L., Staroverov I.N., Lonchakova O.M., Pamputis S.N., Zavyalov D.V., Baranov G.A.

More about the authors

Journal: Journal of Venous Disorders. 2024;18(3): 207‑213

DOI: 10.17116/flebo202418031207

Downloaded: 6

Contact the author

Table of contents

To cite this article:

Chervyakov YuV, Komlev DL, Staroverov IN, Lonchakova OM, Pamputis SN, Zavyalov DV, Baranov GA. Surgery in Patients with Renal Cell Carcinoma and Tumor Thrombus of Inferior Vena Cava. Journal of Venous Disorders. 2024;18(3):207‑213. (In Russ.)
https://doi.org/10.17116/flebo202418031207

Подписка 2025-2 (Journal of Venous Disorders)

Close metadata

OBJECTIVE

To present surgical treatment of patients with renal cell carcinoma complicated by tumor thrombosis of inferior vena cava.

MATERIAL AND METHODS

Surgical interventions were performed in 21 patients (mean age 59 years) with renal cell carcinoma T3b and T3c, N0-1, M0 stage. There were 17 (81%) men and 4 (19%) women. Tumor thrombosis of inferior vena cava arose from the right kidney in 16 (76%) cases and left kidney in 5 (24%) cases. All patients underwent nephrectomy and different types of thrombectomy from inferior vena cava with subsequent lymph node dissection. All patients received postoperative anticoagulant therapy.

RESULTS

Inferior vena cava patency was restored in all cases. Postoperative mortality was 9.5%. We estimated treatment outcomes throughout a year in 84% of cases. Thrombotic recurrent occlusion of infrarenal IVC occurred in 2 out of 5 patients. There was no recurrent thrombosis of suprarenal IVC and contralateral renal vein. Fatal outcome occurred in 4 patients in 5, 7, 8 and 11 months after surgery from progression of cancer. Annual survival rate was 75%.

CONCLUSION

Surgery for renal cell carcinoma complicated by tumor thrombosis of IVC should include vein recanalization. This intervention is relatively safe and associated with higher annual survival.

Keywords:

kidney cancer

inferior vena cava

tumor thrombus

surgery

VTE

Authors:

Chervyakov Yu.V.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0001-5270-9968

Komlev D.L.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0003-4180-5326

Staroverov I.N.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0001-9855-9467

Lonchakova O.M.

Yaroslavl State Medical University;
Yaroslavl Regional Clinical Hospital

ORCID: 0000-0003-4507-6693

Pamputis S.N.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0002-7880-1081

Zavyalov D.V.

Yaroslavl Regional Clinical Hospital

ORCID: 0000-0002-9173-6878

Baranov G.A.

Russian University of Medicine

ORCID: 0000-0003-1394-4185

Received:

18.12.2023

Accepted:

15.03.2024

List of references:

Zlokachestvennye novoobrazovaniya v Rossii v 2021 godu (zabolevaemost’ i smertnost’). Kaprin AD, Starinsky VV, Shakhzadova AO, eds. M. 2022. (In Russ.).
Aksel EM, Matveev VB. Statistics of malignant neoplasms of the urinary and male genital organs in Russia and the countries of the former USSR. Oncourology. 2019;15(2):15-24. (In Russ.).
Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, Giles RH, Hofmann F, Hora M, Kuczyk MA, Kuusk T, Lam TB, Marconi L, Merseburger AS, Powles T, Staehler M, Tahbaz R, Volpe A, Bex A. EAU Guidelines on Renal Cell Carcinoma. European Association of Urology: The 2019 Update. Eur Urol. 2019;75(5):799-810. https://doi.org/10.1016/j.eururo.2019.02.011
Freifeld Y, Woldu SL, Singla N, Clinton T, Bagrodia A, Hutchinson R, Lotan Y, Margulis V. Impact of hospital case volume on outcomes following radical nephrectomy and inferior vena cava thrombectomy. Eur Urol Oncol. 2019;2(6):691-698. https://doi.org/10.1016/j.euo.2018.10.005
Davydov MI, Matveev VB, Matveev BP. Khirurgicheskoe lechenie raka pochki, oslozhnennogo venoznoj invaziej (posobie dlya vrachej). M. 2003. (In Russ.).
Serena G, Gonzalez J, Gaynor JJ, Salerno T, Verzaro R, Ciancio G. Pulmonary tumor embolization as early manifestation in patients with renal cell carcinoma and tumor thrombus: Perioperative management and outcomes. J Card Surg. 2019;34(10):1018-1023. https://doi.org/10.1111/jocs.14182
Novara G, Ficarra V, Antonelli A, Artibani W, Bertini R, Carini M, Cosciani Cunico S, Imbimbo C, Longo N, Martignoni G, Martorana G, Minervini A, Mirone V, Montorsi F, Schiavina R, Simeone C, Serni S, Simonato A, Siracusano S, Volpe A, Carmignani G; SATURN Project LUNA Foundation. Validation of the 2009 TNM version in a large multiinstitutional cohort of patients treated for renal cell carcinoma: are further improvements needed? Eur Urol. 2010;58:588-595.
Bachmann A, Seitz M, Gaser A, Reiser MF, Schäfers HJ, Löhe F, Jauch KW, Stief CG. Tumor nephrectomy with vena cava thrombus. BJU Int. 2005; 95:1373-1384.
Blute ML, Leibovich BC, Lohse ChM, Cheville JC, Zincke H. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumor thrombus. BJU Int. 2004;94:33-41.
Khvastunov RA, Yusifova AA. Surgical treatment of kidney cancer complicated by tumor thrombosis of the inferior vena cava. Volgograd Scientific and Medical Journal. 2017;2:58-61. (In Russ.).
Davidov MI, Matveev VB, Volkova MI, Figurin KM, Feoktistov PI, Lomidze SV, Zhuzhginova OV, Nekhaev IV, Ogorodnikova EV. Surgical treatment of kidney cancer complicated by tumor venous thrombosis of levels III-IV. Oncourology. 2016;12(4):21-34. (In Russ.).
Moik F, Colling M, Mahé I, Jara-Palomares L, Pabinger I, Ay C. Extended anticoagulation treatment for cancer-associated thrombosis-Rates of recurrence and bleeding beyond 6 months: A systematic review. J Thromb Haemos. 2022;20(3):619-634.
Zavaruev AV, Zavaruev VN, Mazurenko AA, Komarov RN, Anikin SV. Long-term results of surgical treatment of malignant neoplasms of the kidneys complicated by tumor thrombosis of the renal and inferior vena cava. Journal of Venous Disorders. 2021;15(3):139-143. (In Russ.).
Gavrilov EK, Tarasov VA, Khubulava GG. Experience in diagnostics, therapeutic tactics and surgical interventions for obstruction of the inferior vena cava of various origins. Journal of Venous Disorders. 2020;14(4):346-355. (In Russ.).
Seliverstov EI, Lobastov KV, Ilyukhin EA, Apkhanova TV, Akhmetzyanov RV, Akhtyamov IF, Barinov VE, Bakhmetiev AS, Belov MV, Bobrov SA, Bozhkova SA, Bredikhin RA, Bulatov VL, Vavilova TV, Vardanyan AV, Vorobiev NA, Gavrilov EK, Gavrilov SG, Golovina VI, Gorin AS, Dzhenina OV, Dianov SV, Efremova OI, Zhukovets VV, Zamyatin MN, Ignatiev IA, Kalinin RE, Kamaev AA, Kaplunov OA, Karimova GN, Karpenko AA, Kasimova AR, Katelnitskaya OV, Katelnitsky II, Katorkin SE, Knyazev RI, Konchugova TV, Kopenkin SS, Koshevoy AP, Kravtsov PF, Krylov AYu, Kulchitskaya DB, Laberko LA, Lebedev IS, Malanin DA, Matyushkin AV, Mzhavanadze ND, Moiseev SV, Mushtin NE, Nikolaeva MG, Pelevin AV, Petrikov AS, Piradov MA, Pikhanova ZhM, Poddubnaya IV, Porembskaya OYa, Potapov MP, Pyregov AV, Rachin AP, Rogachevsky OV, Ryabinkina YuV, Sapelkin SV, Sonkin IN, Soroka VV, Sushkov SA, Schastlivtsev IV, Tikhilov RM, Tryakin AA, Fokin AA, Khoronenko VE, Khruslov MV, Tsaturyan AB, Tsed AN, Cherkashin MA, Chechulova AV, Chuiko SG, Shimanko AI, Shmakov RG, Yavelov IS, Yashkin MN, Kirienko AI, Zolotukhin IA, Stoyko YuM, Suchkov IA. Prevention, Diagnostics and Treatment of Deep Vein Thrombosis. Russian Experts Consensus. Journal of Venous Disorders. 2023;17(3):152-296. (In Russ.). https://doi.org/10.17116/flebo202317031152
Somonova OV, Antukh EA, Vardanyan AV, Gromova EG, Dolgushin BI, Elizarova AL, Sakaeva DD, Sel’chuk VYu, Tryakin AA, Cherkasov VA. Prakticheskie rekomendatsii po profilaktike i lecheniyu tromboembolicheskikh oslozhnenij u onkologicheskikh bol’nykh. Zlokachestvennye opukholi: prakticheskie rekomendatsii. RUSSCO. 2022;12:159-170. (In Russ.).

Close metadata