RENAL-CELL CARCINOMA EXTENDING INTO THE VENA-CAVA-LIMITATION OF PROGNOSIS

被引：3

作者：

ALLHOFF, EP

PICHLMAYR, R

GEBEL, M

LAAS, J

机构：

[1] Klinik und Poliklinik für Urologie, Zentrum Chirurgie der Medizinischen Hochschule Hannover

[2] Klinik für Abdominal- und Transplantationschirurgie, Zentrum Chirurgie der Medizinischen Hochschule Hannover

[3] Abteilung Gastroenterologie und Hepatologie, Zentrum Innere Medizin der Medizinischen Hochschule Hannover

[4] Klinik für Thorax-, Herz- und Gefäßchirurgie Zentrum Chirurgie der Medizinischen Hochschule Hannover

来源：

AKTUELLE UROLOGIE | 1991年 / 22卷 / 06期

关键词：

RENAL CELL CARCINOMA; TUMOR THROMBUS; CAVA THROMBUS; COLOR DOPPLER SONOGRAPHY;

D O I：

10.1055/s-2008-1060527

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Differentiated multifactorial analyses performed over the last 10 years have indicated that a caval tumor thrombus alone does not impact unfavourably on the prognosis of renal cell cancer. The postoperative course of this type of tumor disease seems rather to be determined by classical tumor parameters such as perinephric fat involvement, lymphatic spread and distant metastases. Furthermore, comprehensive diagnostic work-up integrating colour-coded sonography or nuclear magnetic resonance is essential for precise assessment of tumor thrombus extension, presence or absence of vena caval side wall invasion, a thorough search for metastatic spread and proper cardiovascular evaluation. This enables careful preoperative planning and competent surgery utilizing an aggressive multispecialty approach, if necessary. Visual endoluminal inspection allows for complete resection, the primary determinant of prolonged survival, with partial venacavectomy and adequate vascular reconstruction, if required. Resectability of distant metastatic lesions makes an ultraradical approach feasible.

引用

页码：333 / 338

页数：6

共 27 条

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