Surgical treatment of renal cell carcinoma with tumor thrombus in inferior vena cava

Removal of renal cell carcinoma (RCC) extended into the inferior vena cava (IVC) can be a difficult operation. Between 1941 and 1989, 110 RCC patients were treated with radical operation and examined for tumor thrombus histopathologically. Twenty nine (26.3%) patients had invasion into the returning vein of tumor (Stage Vla), 12 (10.9%) in renal vein (stage Vlb) and the remaining 4 (3.6%) into IVC (stage V2). In one patient who had surgery under extracorporeal circulation, a thrombus was extended into the right atrium. In the remaining three patients, the RCC was confined to a small portion of the IVC and operated by caval sleeve resection. Radical operation in such patients free of any distant metastasis, may raise the survival rate.