Top

Current Urology Reports

Published in:

01-04-2021 | Nephrectomy | Kidney Diseases (G Ciancio, Section Editor)

Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension

Authors: Alberto Jurado, Agustin Romeo, Guillermo Gueglio, Patricio Garcia Marchiñena

Published in: Current Urology Reports | Issue 4/2021

Abstract

Purpose of Review

To review the evidence regarding the current trends in surgical management of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis. Recent published series have shown the role of minimally invasive surgery in IVC thrombectomy. This review article evaluates the present RCC with venous extent literature to assess the role of open and minimally invasive surgery in this scenario.

Recent Findings

Robotic urological surgery has shown to have known benefits in radical prostatectomy, partial nephrectomy, and pyeloplasty. Recent published series showed feasibility of robotic IVC thrombectomy even for level IV cases.

Summary

With growing number of robot-assisted and laparoscopic surgeries worldwide, there is a current tendency to treat this complex and challenging pathology with a minimally invasive approach, without compromising oncological outcomes.

Huang WC, Becher E. Current landscape of advanced and metastatic renal cell carcinoma management. Urol Clin North Am. 2020;47(3):xiii-xiv. doi:https://doi.org/10.1016/j.ucl.2020.05.001

Laguna MP, Algaba F, Cadeddu J, Clayman R, Gill I, Gueglio G, et al. Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study. J Endourol. 2014;28(7):861–70. https://doi.org/10.1089/end.2013.0724.CrossRefPubMed

Ciancio G, Manoharan M, Katkoori D, De Los SR, Soloway MS. Long-term survival in patients undergoing radical nephrectomy and inferior vena cava thrombectomy: single-center experience. Eur Urol. 2010;57(4):667–72. https://doi.org/10.1016/j.eururo.2009.06.009.CrossRefPubMed

Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, et al. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146(2):278–82. https://doi.org/10.1016/s0022-5347(17)37770-4.CrossRefPubMed

Abaza R. Initial series of robotic radical nephrectomy with vena caval tumor thrombectomy. Eur Urol. 2011;59(4):652–6. https://doi.org/10.1016/j.eururo.2010.08.038.CrossRefPubMed

Laird A, Choy KCC, Delaney H, Cutress ML, O’Connor KM, Tolley DA, et al. Matched pair analysis of laparoscopic versus open radical nephrectomy for the treatment of T3 renal cell carcinoma. World J Urol. 2015;33:25–32. https://doi.org/10.1007/s00345-014-1280-y.CrossRefPubMed

Bragayrac LA, Abbotoy D, Attwood K, et al. Outcomes of minimal invasive vs open radical nephrectomy for the treatment of locally advanced renal-cell carcinoma. J Endourol. 2016;30(8):871–6. https://doi.org/10.1089/end.2016.0082.CrossRefPubMed

Becher E, Jericevic D, Huang WC. Minimally invasive surgery for patients with locally advanced and/or metastatic renal cell carcinoma. Urol Clin North Am. 2020;47(3):389–97. https://doi.org/10.1016/j.ucl.2020.04.004.CrossRefPubMed

Hevia V, Ciancio G, Gómez V, Álvarez S, Díez-Nicolás V, Burgos FJ. Surgical technique for the treatment of renal cell carcinoma with inferior vena cava tumor thrombus: tips, tricks and oncological results. Springerplus. 2016;5:132. Published 2016 Feb 20. doi:https://doi.org/10.1186/s40064-016-1825-1

10.

Sundaram CP, Rehman J, Landman J, Oh J. Hand assisted laparoscopic radical nephrectomy for renal cell carcinoma with inferior vena caval thrombus. J Urol. 2002;168(1):176–9.CrossRef

11.

Martin GL, Castle EP, Martin AD, Desai PJ, Lallas CD, Ferrigni RG, et al. Outcomes of laparoscopic radical nephrectomy in the setting of vena caval and renal vein thrombus: seven-year experience. J Endourol. 2008;22(8):1681–5. https://doi.org/10.1089/end.2008.0035.CrossRefPubMed

12.

Xiao X, Zhang L, Chen X, Cui L, Zhu H, Pang D, et al. Surgical management of renal cell carcinoma extending into venous system: a 20-year experience. Scand J Surg. 2018;107(2):158–65. https://doi.org/10.1177/1457496917738922.CrossRefPubMed

13.

Martínez-Salamanca JI, Huang WC, Millán I, Bertini R, Bianco FJ, Carballido JA, et al. Prognostic impact of the 2009 UICC/AJCC TNM staging system for renal cell carcinoma with venous extension. Eur Urol. 2011;59(1):120–7. https://doi.org/10.1016/j.eururo.2010.10.001.CrossRefPubMed

14.

Wilkinson CJ, Kimovec MA, Uejima T. Cardiopulmonary bypass in patients with malignant renal neoplasms. Br J Anaesth. 1986;58:461–5.CrossRef

15.

Libertino, J. A.: Renal cell cancer with extension into the vena cava. In: Rob & Smith’s operative surgery: urology, 4th ed. Edited by W. S. McDougal. London: Butterworths, p. 127, 1986.

16.

Stief CG, Schafers HJ, Kuczyk M. Renal-cell carcinoma with intracaval neoplastic extension: stratification and surgical technique. World J Urol. 1995;13(3):166–70.CrossRef

17.

Belis JA, Pae WE, Rohner TJ. Cardiovascular evaluation before circulatory arrest for removal of vena caval extension of renal carcinoma. J Urol. 1989;141(6):1302–7.CrossRef

18.

Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol. 1987;59:390–5.CrossRef

19.

Blute ML, Leibovich BC, Lohse CM, Cheville JC, Zincke H. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int. 2004;94(1):33–41. https://doi.org/10.1111/j.1464-410X.2004.04897.CrossRefPubMed

20.

Ciancio G, Vaidya A, Savoie M, Soloway M. Management of renal cell carcinoma with level III thrombus in the inferior vena cava. J Urol. 2002;168(4 Pt 1):1374–7. https://doi.org/10.1097/01.ju.0000023441.00587.02.CrossRefPubMed

21.

Wang B, Huang Q, Liu K, Fan Y, Peng C, Gu L, et al. Robot-assisted level III-IV inferior vena cava thrombectomy: initial series with step-by-step procedures and 1-yr outcomes. Eur Urol. 2020;78(1):77–86. https://doi.org/10.1016/j.eururo.2019.04.019.CrossRefPubMed

22.

Campi R, Tellini R, Sessa F, et al. Techniques and outcomes of minimally-invasive surgery for nonmetastatic renal cell carcinoma with inferior vena cava thrombosis: a systematic review of the literature. Minerva Urol Nefrol. 2019;71(4):339–358. https://doi.org/10.23736/S0393-2249.19.03396-4.

23.

Abaza R, Eun DD, Gallucci M, Gill IS, Menon M, Mottrie A, et al. Robotic surgery for renal cell carcinoma with vena caval tumor thrombus. Eur Urol Focus. 2016;2(6):601–7. https://doi.org/10.1016/j.euf.2017.01.001.CrossRefPubMed

24.

Ciancio G, Hawke C, Soloway M. The use of liver transplant techniques to aid in the surgical management of urological tumors. J Urol. 2000;164(3 Pt 1):665–72. https://doi.org/10.1097/00005392-200009010-00012.CrossRefPubMed

25.

Chan AA, Abel J, Carrasco A, et al. Impact of preoperative renal artery embolization on surgical outcomes and overall survival in patients with renal cell carcinoma and inferior vena cava thrombus. J Urol. 2011;185(Suppl):e707–8.

26.

Tang Q, Li X, Song Y, Wang J, He Z, Zhou L. Application of preoperative renal artery embolization in patients with renal cell carcinoma and venous tumor thrombus: an effective preoperative adjuvant therapy for patients with advanced tumor thrombus. Eur Urol Suppl. 2014;13:e938.CrossRef

27.

Romero FR, Muntener M, Herman S. Bagga, et al. Pure laparoscopic radical nephrectomy with level II vena caval thrombectomy. Urology. 2006;68(5):1112–4, ISSN 0090-4295. https://doi.org/10.1016/j.urology.2006.08.1084.CrossRefPubMed

28.

Chopra S, Simone G, Metcalfe C, de Castro Abreu AL, Nabhani J, Ferriero M, et al. Robot-assisted level II–III inferior vena cava tumor thrombectomy: step-by-step technique and 1-year outcomes. Eur Urol. 2017;72(2):267–74, ISSN 0302-2838. https://doi.org/10.1016/j.eururo.2016.08.066.CrossRefPubMed

29.

Klink JC, Westesson KE, Gao T, Stephenson AJ, Krishnamurthi V. Tumor thrombus transection in renal cell carcinoma. J Clin Oncol. 2013;31:4090. https://doi.org/10.1200/jco.2013.31.6_suppl.409.CrossRef

30.

Kundavaram C, Abreu AL, Chopra S, et al. Advances in robotic vena cava tumor thrombectomy: intracaval balloon occlusion, patch grafting, and vena cavoscopy. Eur Urol. 2016;70(5):884–90. https://doi.org/10.1016/j.eururo.2016.06.024.CrossRefPubMed

31.

Alahmari A, Alzahrani Z, Algarni KS, et al. Robotic inferior vena cava thrombectomy using a novel intracaval balloon occlusion technique. Cent European J Urol. 2020;73:106–7.PubMedPubMedCentral

32.

Gill IS, Metcalfe C, Abreu A, Duddalwar V, Chopra S, Cunningham M, et al. Robotic level III inferior vena cava tumor thrombectomy: initial series. J Urol. 2015;194(4):929–38. https://doi.org/10.1016/j.juro.2015.03.119.CrossRefPubMed

33.

34.

Wang B, Li H, Ma X, Zhang X, Gu L, Li X, et al. Robot-assisted laparoscopic inferior vena cava thrombectomy: different sides require different techniques. Eur Urol. 2016;69:1112–9.CrossRef

35.

Wang B, Li H, Huang Q, Liu K, Fan Y, Peng C, et al. Robot-assisted retrohepatic inferior vena cava thrombectomy: first or second Porta Hepatis as an important boundary landmark. Eur Urol. 2018 Oct;74(4):512–20. https://doi.org/10.1016/j.eururo.2017.11.017.

36.

Van Rees VS, de la Rosette J. The CROES data management system: a glimpse behind the scenes. J Endourol. 2011;25(1):1–5. https://doi.org/10.1089/end.2010.1557.

Title: Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension
Authors: Alberto Jurado
Agustin Romeo
Guillermo Gueglio
Patricio Garcia Marchiñena
Publication date: 01-04-2021
Publisher: Springer US
Keywords: Nephrectomy
Kidney Cancer
Kidney Cancer
Nephrectomy
Kidney Cancer
Nephrectomy
Thrombosis
Minimally Invasive Surgery
Thrombectomy
Published in: Current Urology Reports / Issue 4/2021
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-021-01036-y

At a glance: The STEP trials

Springer Medicine

Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension

Abstract

Purpose of Review

Recent Findings

Summary

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2021

Innovations in Urologic Surgical Training

Marijuana, Alcohol, and ED: Correlations with LUTS/BPH

Erectile and Ejaculatory Dysfunction After Urethroplasty

Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy

Techniques and Outcomes of MRI-TRUS Fusion Prostate Biopsy

State of the Reservoir: Current Concepts of Penile Implant Reservoir Placement and Potential Complications