Maldonado De Sasia A, Antón-Juanilla M, González-Jiménez D, Mosteiro-González L, Gutiérrez-Zurimendi G, Andujar CC, Lecumberri-Castaños D

Language: Spanish
References: 0
Page: 1-8
PDF size: 602.04 Kb.

ABSTRACT

Introduction and objectives: renal cell carcinoma (RCC) with tumor extension to the inferior vena cava (IVC) presents an oncological surgical challenge. The aim of this study was to analyze perioperative outcomes, overall survival (OS), and associated prognostic factors in patients undergoing surgery at a tertiary center.
Methods: retrospective study of 34 patients diagnosed between 2001 and 2024, all of whom underwent radical nephrectomy and thrombectomy. Preoperative evaluation was performed using computed tomography (CT) and magnetic resonance imaging (MRI). Clinical, surgical, and survival variables were analyzed using descriptive methods and univariate and multivariate Cox regression models.
Results: the mean age at diagnosis was 61.9 ± 8.7 years. The thrombus was classified as level I (23.5 %), II (35.3 %), III (26.5 %), and IV (14.7 %) according to Neves and Zincke. Surgery was performed with curative intent in 91.2 % of cases and cytoreductive intent in 8.8 %. Cardiopulmonary bypass was required in 20.6 %. In multivariate analysis, the need for cardiopulmonary bypass (HR = 0.24; 95 % CI: 0.09–0.66; p = 0.005) and lymph node involvement (HR = 0.33; 95 % CI: 0.11–0.96; p = 0.042) were identified as factors associated with a worse prognosis.
Conclusions: colorectal cancer with thrombus in the inferior vena cava presents a surgical challenge. Lymph node involvement and the need for cardiopulmonary bypass are associated with lower survival. Adequate preoperative evaluation and multidisciplinary management are essential to optimize oncological and surgical outcomes.