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Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results
BACKGROUND: To analyze the influence of inferior vena cava (IVC) interruption for perioperative and oncological results in patients with renal cell carcinoma and tumor thrombus and summarize the surgical strategies of IVC interruption for different situations. METHODS: We retrospectively analyzed th...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607562/ https://www.ncbi.nlm.nih.gov/pubmed/34802447 http://dx.doi.org/10.1186/s12893-021-01400-2 |
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author | Liu, Zhuo Zhang, Qiming Zhao, Xun Zhu, Guodong Tang, Shiying Hong, Peng Ge, Liyuan Zhang, Shudong Wang, Guoliang Tian, Xiaojun Zhang, Hongxian Liu, Cheng Ma, Lulin |
author_facet | Liu, Zhuo Zhang, Qiming Zhao, Xun Zhu, Guodong Tang, Shiying Hong, Peng Ge, Liyuan Zhang, Shudong Wang, Guoliang Tian, Xiaojun Zhang, Hongxian Liu, Cheng Ma, Lulin |
author_sort | Liu, Zhuo |
collection | PubMed |
description | BACKGROUND: To analyze the influence of inferior vena cava (IVC) interruption for perioperative and oncological results in patients with renal cell carcinoma and tumor thrombus and summarize the surgical strategies of IVC interruption for different situations. METHODS: We retrospectively analyzed the clinical and pathological data of 103 patients in our center. Patients were divided into two groups with 32 cases (31.1%) underwent IVC interruption (Group 1) while 71 cases (68.9%) did not. For comparison of continuous variables, the Mann–Whitney U test was used. For comparison of categorical variables, Chi-square tests were used. A propensity score based matching method was used to eliminate possible bias. Kaplan–Meier plots were performed to evaluate the influence of IVC interruption on overall survival and cancer specific survival. All the statistical analyses were performed using SPSS 24. A P value < 0.05 was considered statistically significant. RESULTS: Among the 32 patients who underwent IVC interruption, the median age was 61 years and the median tumor size was 7.7 cm. There were 28 males and 23 tumors were on the right side. We successfully matched 29 patients who underwent IVC interruption to 29 patients without this procedure in 1:1 ratio. No significant differences existed in baseline characteristics between the groups. The comparison of perioperative data showed that patients who underwent IVC interruption had significantly longer median postoperative hospital stays (13 vs 9 days, P = 0.022) and a higher overall postoperative complication rate (79.3 vs 51.7%, P = 0.027). According to the side and shape of tumor thrombus, it could be divided into four categories. There were 15 cases (46.9%) with right filled-type tumor thrombus (RFTT), 8 cases (25.0%) with right non-filled-type tumor thrombus (RNFTT), 1 case (3.1%) with left filled-type tumor thrombus (LFTT) and 8 cases (25.0%) with left non-filled-type tumor thrombus (LNFTT). According to different categories, different surgical procedures were adopted. CONCLUSIONS: IVC interruption will increase the incidence of overall postoperative complications, but not the risk of major postoperative complications. Tumor thrombus should be divided into four categories, and different sides and shapes of renal tumor thrombus need different operative procedure of IVC interruption. |
format | Online Article Text |
id | pubmed-8607562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-86075622021-11-22 Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results Liu, Zhuo Zhang, Qiming Zhao, Xun Zhu, Guodong Tang, Shiying Hong, Peng Ge, Liyuan Zhang, Shudong Wang, Guoliang Tian, Xiaojun Zhang, Hongxian Liu, Cheng Ma, Lulin BMC Surg Research Article BACKGROUND: To analyze the influence of inferior vena cava (IVC) interruption for perioperative and oncological results in patients with renal cell carcinoma and tumor thrombus and summarize the surgical strategies of IVC interruption for different situations. METHODS: We retrospectively analyzed the clinical and pathological data of 103 patients in our center. Patients were divided into two groups with 32 cases (31.1%) underwent IVC interruption (Group 1) while 71 cases (68.9%) did not. For comparison of continuous variables, the Mann–Whitney U test was used. For comparison of categorical variables, Chi-square tests were used. A propensity score based matching method was used to eliminate possible bias. Kaplan–Meier plots were performed to evaluate the influence of IVC interruption on overall survival and cancer specific survival. All the statistical analyses were performed using SPSS 24. A P value < 0.05 was considered statistically significant. RESULTS: Among the 32 patients who underwent IVC interruption, the median age was 61 years and the median tumor size was 7.7 cm. There were 28 males and 23 tumors were on the right side. We successfully matched 29 patients who underwent IVC interruption to 29 patients without this procedure in 1:1 ratio. No significant differences existed in baseline characteristics between the groups. The comparison of perioperative data showed that patients who underwent IVC interruption had significantly longer median postoperative hospital stays (13 vs 9 days, P = 0.022) and a higher overall postoperative complication rate (79.3 vs 51.7%, P = 0.027). According to the side and shape of tumor thrombus, it could be divided into four categories. There were 15 cases (46.9%) with right filled-type tumor thrombus (RFTT), 8 cases (25.0%) with right non-filled-type tumor thrombus (RNFTT), 1 case (3.1%) with left filled-type tumor thrombus (LFTT) and 8 cases (25.0%) with left non-filled-type tumor thrombus (LNFTT). According to different categories, different surgical procedures were adopted. CONCLUSIONS: IVC interruption will increase the incidence of overall postoperative complications, but not the risk of major postoperative complications. Tumor thrombus should be divided into four categories, and different sides and shapes of renal tumor thrombus need different operative procedure of IVC interruption. BioMed Central 2021-11-21 /pmc/articles/PMC8607562/ /pubmed/34802447 http://dx.doi.org/10.1186/s12893-021-01400-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Liu, Zhuo Zhang, Qiming Zhao, Xun Zhu, Guodong Tang, Shiying Hong, Peng Ge, Liyuan Zhang, Shudong Wang, Guoliang Tian, Xiaojun Zhang, Hongxian Liu, Cheng Ma, Lulin Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title | Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title_full | Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title_fullStr | Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title_full_unstemmed | Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title_short | Inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
title_sort | inferior vena cava interruption in renal cell carcinoma with tumor thrombus: surgical strategy and perioperative results |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8607562/ https://www.ncbi.nlm.nih.gov/pubmed/34802447 http://dx.doi.org/10.1186/s12893-021-01400-2 |
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