Renal cell carcinoma with intracardiac tumor thrombus extension: Radical surgery yields 2 years of postoperative survival in a single-center study over a period of 30 years

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F23%3A10454564" target="_blank" >RIV/00179906:_____/23:10454564 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11150/23:10454564

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=a-OT89Pj4k" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=a-OT89Pj4k</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3389/fonc.2023.1137804" target="_blank" >10.3389/fonc.2023.1137804</a>

Result language

angličtina

Original language name

Renal cell carcinoma with intracardiac tumor thrombus extension: Radical surgery yields 2 years of postoperative survival in a single-center study over a period of 30 years

Original language description

Background: Renal cell carcinoma (RCC) with tumor thrombus extension into the right atrium (level IV) is a rare life-threatening clinical condition that can only be managed by means of a combined urological and cardiac surgical approach. The early and late outcomes of this radical treatment were analyzed in a large single-institution series over a period of 30 years.Methods: In 37 patients with RCC and intracardiac tumor thrombus extension, nephrectomy was performed followed by the extraction of the intracaval and intracardiac tumor thrombus under direct visual control during deep hypothermic circulatory arrest (DHCA). Recently, in 13 patients, selective aortic arch perfusion (SAAP) was instituted during DHCA.Results: In all patients, precise removal of the tumor thrombus was accomplished in a bloodless field. The mean duration of isolated DHCA was 15 +- 6 min, and 31.5 +- 10.2 min in the case of DHCA + SAAP, at a mean hypothermia of 22.7 +- 4°C. In-hospital mortality was 7.9% (3 patients). In Kaplan-Meier analysis, the estimated median survival was 26.4 months whereas the 5-year cancer-related survival rate was 51%.Conclusions: Despite its complexity, this extensive procedure can be performed safely with a generally uneventful postoperative course. The use of cardiopulmonary bypass with DHCA, with the advantage of SAAP, allows for a safe, precise, and complete extirpation of intracaval and intracardiac tumor mass. Late outcomes after radical surgical treatment in patients with RCC and tumor thrombus reaching up in the right atrium in our series justify this extensive procedure.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

<a href="/en/project/EF16_013%2F0001674" target="_blank" >EF16_013/0001674: BBMRI-CZ: Biobank network - a versatile platform for the research of the etiopathogenesis of diseases</a><br>

Continuities

—

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Frontiers in Oncology

ISSN

2234-943X

e-ISSN

2234-943X

Volume of the periodical

13

Issue of the periodical within the volume

FEB

Country of publishing house

CH - SWITZERLAND

Number of pages

7

Pages from-to

1137804

UT code for WoS article

000932248700001

EID of the result in the Scopus database

2-s2.0-85148343661