Tumor thrombus involving the inferior vena cava in renal malignancy: Is there a difference in clinical presentation and outcome among right and left side tumors?

Devendar Katkoori, Manoharan Murugesan, Gaetano Ciancio, Mark S Soloway

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Purpose: Renal cell carcinoma (RCC) has a propensity to propagate into the renal vein and inferior vena cava (IVC). Due to inherent differences in the venous anatomy of the right and left kidneys, tumor thrombus involvement of IVC may vary. The aim of this study is to compare clinical presentation and outcome of right vs. left RCC with IVC thrombus. Materials and Methods: Patients who underwent radical nephrectomy and IVC thrombectomy between 1997 and 2008 were identified. All relevant data were collected and analyzed. Results: Eight-seven patients were included. Sixty patients (69%) had a right sided tumor. Mean tumor size was 10.2 (± 4) cm and was not significantly different on either side. Fifty-six percent of right sided tumors had level-III (intra-hepatic) or higher tumor thrombus, while 22% of left sided tumors had similar level thrombus extension (p < 0.0001). Nearly 50% of left sided tumors showed level-I thrombus compared to 10% of right side tumors. A comparison of age, estimated blood loss and transfusion rate was not significantly different. The recurrence free (p = 0.9) and disease specific survival (p = 0.4) were not significantly different between the right and left side tumors with IVC thrombus. Conclusion: A level-III IVC tumor thrombus is more frequently seen with a right side tumor. However, clinical and operative characteristics among the left and right sided tumors with IVC thrombus were not different. More significantly, recurrence rate and survival did not differ with the laterality of the tumor.

Original languageEnglish (US)
Pages (from-to)652-656
Number of pages5
JournalInternational Braz J Urol
Volume35
Issue number6
DOIs
StatePublished - Nov 2009

Keywords

  • Inferior
  • Kidney neoplasms
  • Nephrectomy
  • Thrombectomy
  • Vena cava

ASJC Scopus subject areas

  • Urology

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