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Multicenter Study
. 2025 Sep 9;43(1):544.
doi: 10.1007/s00345-025-05914-9.

Management of renal cancer with inferior vena cava extension over 30 years: a bi-centric study

Thomas Poirier  1 , Benoit Mesnard  2 , Mathieu Roumiguie  3 , Stephane De Vergie  2 , Cloe Geay  4 , Julien Branchereau  2 , Thomas Prudhomme  5 , Jerome Rigaud  2
Affiliations
Multicenter Study

Management of renal cancer with inferior vena cava extension over 30 years: a bi-centric study

Thomas Poirier et al. World J Urol. .

Abstract

Purpose: In 5-10% of cases, renal cancer extends into the venous system, particularly the inferior vena cava (IVC), which worsens prognosis. This study aims to assess morbidity, mortality, and oncological outcomes of patients treated surgically for renal cancer with IVC extension over a 30-year period, in two experienced centers.

Materials and methods: This bicentric, retrospective study analyzed patients treated between 1988 and 2020 for renal cancer involving the IVC. Surgical approach varied based on thrombus level, with CPB mostly employed for thrombi above the hepatic veins.

Results: From 1988 to 2020, 213 patients were treated. Thrombi below the hepatic veins were found in 137 patients (64.3%), while 76 (35.7%) had thrombi above the hepatic veins. Synchronous metastases were identified in 34.3%. Median blood loss was 1.75 L. Transfusions were required in 81.8%.CPB use significantly extended hospital stay (p < 0.001) and increased complication rates (p < 0.01). Morbidity was recorded in 53% of patients. Postoperative mortality within 30 days occurred in 9.4% of cases. Median follow-up was 25 months. The 2- and 5-year OS rates were 50.2% and 29.6%, respectively. In multivariate analysis, M + and pN + status at diagnosis were the primaries prognostics factors for OS (HR = 1.54, p = 0.033 and HR = 2.21, p = 0.002). The 2 and 5 years PFS were 25.3% and 11.7%, respectively.

Conclusion: Renal cancer with IVC extension remains a highly aggressive disease with poor prognosis. While surgery offers a potential cure for some patients, the high rates of perioperative morbidity and mortality remain a challenge.

Keywords: Inferior vena cava thrombus; Kidney Cancer; Kidney cancer surgery; Locally advanced kidney cancer.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval: The research adhered to French laws for studies not involving human participants (non-Jardé law research). Consent to participate: Patient consent was obtained in compliance with the MR-003 reference procedure (National Commission on Informatics and Liberty, CNIL). No. 22221375 v 0. Approval committee: The study received favorable ethical committee approval. (GNEDS No. 24-1-01-110).

References

    1. Ljungberg B, Albiges L, Abu-Ghanem Y, Bedke J, Capitanio U, Dabestani S, Fernández-Pello S, Giles RH, Hofmann F, Hora M, Klatte T, Kuusk T, Lam TB, Marconi L, Powles T, Tahbaz R, Volpe A, Bex A (2022) European association of urology guidelines on renal cell carcinoma: the 2022 update. Eur Urol 82(4):399–410 (Epub 2022 Mar 26. PMID: 35346519) - DOI - PubMed
    1. Wagner B, Patard JJ, Méjean A, Bensalah K, Verhoest G, Zigeuner R et al (2009) Prognostic value of renal vein and inferior vena cava involvement in renal cell carcinoma. Eur Urol 55(2):452–460 - DOI - PubMed
    1. Adams LC, Ralla B, Bender YNY, Bressem K, Hamm B, Busch J et al (2018) Renal cell carcinoma with venous extension: prediction of inferior vena cava wall invasion by MRI. Cancer Imaging 18(1):17 - DOI - PubMed - PMC
    1. Sweeney P, Wood CG, Pisters LL, Slaton JW, Vaporciyan A, Munsell M et al (2003) Surgical management of renal cell carcinoma associated with complex inferior vena caval thrombi. Urol Oncol 21(5):327–333 - DOI - PubMed
    1. Rigaud J, Hetet JF, Braud G, Battisti S, Le Normand L, Glemain P, Karam G, Bouchot O (2006) Surgical care, morbidity, mortality and follow-up after nephrectomy for renal cancer with extension of tumor thrombus into the inferior Vena cava: retrospective study since 1990s. Eur Urol 50(2):302–310 - DOI - PubMed

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