Contemporary techniques and safety of cardiovascular procedures in the surgical management of renal cell carcinoma with tumor thrombus

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dc.contributor.authorLubahn, Jordon G.
dc.contributor.authorSagalowsky, Arthur I.
dc.contributor.authorRosenbaum, David H.
dc.contributor.authorDikmen, Erkan
dc.contributor.authorBhojani, Rehal A.
dc.contributor.authorPaul, Michelle C.
dc.contributor.authorDiMaio, J. Michael
dc.date.accessioned2020-06-25T17:43:32Z
dc.date.available2020-06-25T17:43:32Z
dc.date.issued2006
dc.description.abstractObjective: Renal cell carcinomas often form venous thrombi that extend into the vena cava. Frequently, cardiovascular consultation is necessary for complete surgical excision. We sought to investigate the risk factors, surgical techniques, and outcomes of patients treated for renal cell carcinoma with venous extension. Methods: We reviewed the records of 46 consecutive patients who underwent surgical management of renal cell carcinoma with venous extension between 1991 and 2005. Data on patient history, staging, surgical techniques, morbidity, and survival were analyzed. Results: There were 29 men and 17 women with a mean age of 60.2 +/- 12.0 years. Twenty-five (54%) procedures were completed with cardiovascular assistance. Nephrectomy was performed in 44 (96%) cases. Three (7%) patients underwent right heart venovenous bypass, and 2 (5%) patients underwent cardiopulmonary bypass with circulatory arrest. Fourteen (32%) patients had perioperative complications, including 1 (2%) perioperative death. Patients who required cardiovascular procedures ( inferior vena cava clamping, right heart venovenous bypass, and cardiopulmonary bypass with circulatory arrest) had higher risks of perioperative complications ( P <.02). The 1-, 2-, and 5-year overall survival rates were 78%, 69%, and 56%. Conclusions: This large series demonstrates that aggressive treatment of renal cell carcinoma with venous thrombus provides favorable outcomes. Our 5-year survival is among the highest of recent reviews, and our perioperative morbidity and mortality rates are comparable with those of other series. Tumors that require cardiovascular procedures are associated with increased complications when compared with radical nephrectomy and thrombectomy alone. Nevertheless, this aggressive treatment approach offers encouraging patient survival.en_US
dc.description.sponsorshipNIGMS NIH HHSUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Institute of General Medical Sciences (NIGMS) [5T32 GM08593]en_US
dc.identifier.citationLubahn, J. G., Sagalowsky, A. I., Rosenbaum, D. H., Dikmen, E., Bhojani, R. A., Paul, M. C., Dolmatch, B. L., Josephs, S. C., Benaim, E. A., Levinson, B. S., Wait, M. A., Ring, W. S., & DiMaio, J. M. (2006). Contemporary techniques and safety of cardiovascular procedures in the surgical management of renal cell carcinoma with tumor thrombus. The Journal of thoracic and cardiovascular surgery, 131(6), 1289–1295. https://doi.org/10.1016/j.jtcvs.2006.01.038en_US
dc.identifier.doi10.1016/j.jtcvs.2006.01.038
dc.identifier.endpage1295en_US
dc.identifier.issn0022-5223
dc.identifier.issn1097-685X
dc.identifier.issue6en_US
dc.identifier.pmid16733159
dc.identifier.scopus2-s2.0-33646836480
dc.identifier.scopusqualityQ1
dc.identifier.startpage1289en_US
dc.identifier.urihttps://doi.org10.1016/j.jtcvs.2006.01.038
dc.identifier.urihttps://hdl.handle.net/20.500.12587/3782
dc.identifier.volume131en_US
dc.identifier.wosWOS:000238023300016
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherMosby-Elsevieren_US
dc.relation.ispartofJournal Of Thoracic And Cardiovascular Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleContemporary techniques and safety of cardiovascular procedures in the surgical management of renal cell carcinoma with tumor thrombusen_US
dc.typeArticle

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