Abstract：
OBJECTIVE: The aim of our study was to evaluate the morbidity and mortality, as well as the oncogical results of patients who had undergone surgical procedure for a kidney cancer with thrombus extension into the inferior vena cava.
METHODS: Between January 2004 and April 2020, 57 patients were operated by enlarged nephrectomy with thrombectomy for kidney cancer with thrombus extension in the inferior vena cava. Twelve patients (21%) with the use of cardiopulmonary bypass because the thrombus was upper than the sus-hepatic veins. Twenty-three patients (40.4%) were metastatic at diagnosis.
RESULTS: Perioperative mortality was 10.5%, without difference according to surgical technique. Morbidity during hospitalization was 58%, without difference according to surgical technique. Median follow-up was 40.8±40.1months. Overall survival at 2 and 5years was 60% and 28%, respectively. At 5years, the principal prognostic factor was the metastatic status at diagnosis, in multivariate analysis (OR: 0.15, P=0.03). Progression free survival mean was 28.2±40.2months. Progression free survival at 2 and 5years was 28% and 18%, respectively. All the patients who were metastatic at diagnosis had a recurrence in an average time of 5.7months (median of 3months). Thirteen percent of patients can be considered cured at the end of the study.
CONCLUSIONS: Morbidity and mortality of this surgery remain important. The metastatic status at diagnosis has appeared to be the principal prognostic factor on the survival of these patients.
METHODS: Level 4: retrospective study.
METHODS: Between January 2004 and April 2020, 57 patients were operated by enlarged nephrectomy with thrombectomy for kidney cancer with thrombus extension in the inferior vena cava. Twelve patients (21%) with the use of cardiopulmonary bypass because the thrombus was upper than the sus-hepatic veins. Twenty-three patients (40.4%) were metastatic at diagnosis.
RESULTS: Perioperative mortality was 10.5%, without difference according to surgical technique. Morbidity during hospitalization was 58%, without difference according to surgical technique. Median follow-up was 40.8±40.1months. Overall survival at 2 and 5years was 60% and 28%, respectively. At 5years, the principal prognostic factor was the metastatic status at diagnosis, in multivariate analysis (OR: 0.15, P=0.03). Progression free survival mean was 28.2±40.2months. Progression free survival at 2 and 5years was 28% and 18%, respectively. All the patients who were metastatic at diagnosis had a recurrence in an average time of 5.7months (median of 3months). Thirteen percent of patients can be considered cured at the end of the study.
CONCLUSIONS: Morbidity and mortality of this surgery remain important. The metastatic status at diagnosis has appeared to be the principal prognostic factor on the survival of these patients.
METHODS: Level 4: retrospective study.
摘要：
目的：我们研究的目的是评估发病率和死亡率，以及接受过肾癌手术并有血栓延伸到下腔静脉的患者的手术结果。
方法：在2004年1月至2020年4月之间，57例患者通过扩大肾切除术和血栓切除术治疗肾癌并在下腔静脉内形成血栓。12例（21％）使用体外循环，因为血栓高于肝静脉。23例患者（40.4%）在诊断时发生转移。
结果：围手术期死亡率为10.5%，根据手术技术无差异。住院期间的发病率为58%，根据手术技术无差异。中位随访时间为40.8±40.1个月。2年和5年的总生存率分别为60%和28%。分别。在5年的时候，主要预后因素是诊断时的转移状态，多变量分析（OR：0.15，P=0.03）。无进展生存平均为28.2±40.2个月。2年和5年的无进展生存率分别为28%和18%，分别。所有诊断为转移的患者平均复发时间为5.7个月（中位数为3个月）。在研究结束时，13%的患者可以被认为是治愈的。
结论：该手术的发病率和死亡率仍然很重要。诊断时的转移状态似乎是这些患者生存的主要预后因素。
方法：4级：回顾性研究。
方法：在2004年1月至2020年4月之间，57例患者通过扩大肾切除术和血栓切除术治疗肾癌并在下腔静脉内形成血栓。12例（21％）使用体外循环，因为血栓高于肝静脉。23例患者（40.4%）在诊断时发生转移。
结果：围手术期死亡率为10.5%，根据手术技术无差异。住院期间的发病率为58%，根据手术技术无差异。中位随访时间为40.8±40.1个月。2年和5年的总生存率分别为60%和28%。分别。在5年的时候，主要预后因素是诊断时的转移状态，多变量分析（OR：0.15，P=0.03）。无进展生存平均为28.2±40.2个月。2年和5年的无进展生存率分别为28%和18%，分别。所有诊断为转移的患者平均复发时间为5.7个月（中位数为3个月）。在研究结束时，13%的患者可以被认为是治愈的。
结论：该手术的发病率和死亡率仍然很重要。诊断时的转移状态似乎是这些患者生存的主要预后因素。
方法：4级：回顾性研究。
