Advertisement

Approach to the Management of Large and Advanced Renal Tumors

  • Bimal Bhindi
  • Bradley C. LeibovichEmail author
Chapter

Abstract

The safe and efficacious surgical management of large and advanced renal tumors begins with careful preoperative evaluation and planning. The choice of surgical exposure and approach must be tailored to the tumor size, location, and relevant patient anatomy. Radical nephrectomy should be performed while respecting normal anatomic relationships, even where there is distortion by the tumor. The management of an associated venous thrombus depends on its level. Such cases should be approached as a predominantly vascular procedure, with renal artery control first, venous tumor thrombectomy second, and radical nephrectomy third. Renal cancers invading adjacent structures can be resected en bloc if needed. Although surgery for nonmetastatic advanced renal cancers carries a nontrivial risk of morbidity and mortality, satisfactory oncologic outcomes can be achieved with a thoughtful surgical approach.

Keywords

Renal tumor Renal cell carcinoma Advanced renal cell carcinoma Radical nephrectomy VTT Nephrectomy Inferior vena cava tumor thrombectomy 

References

  1. 1.
    Smaldone MC, Egleston B, Hollingsworth JM, Hollenbeck BK, Miller DC, Morgan TM, et al. Understanding treatment disconnect and mortality trends in renal cell carcinoma using tumor registry data. Med Care. 2017;55(4):398–404.PubMedPubMedCentralCrossRefGoogle Scholar
  2. 2.
    Znaor A, Lortet-Tieulent J, Laversanne M, Jemal A, Bray F. International variations and trends in renal cell carcinoma incidence and mortality. Eur Urol. 2015;67(3):519–30.PubMedCrossRefGoogle Scholar
  3. 3.
    Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA. 1999;281(17):1628–31.CrossRefGoogle Scholar
  4. 4.
    Chow WH, Dong LM, Devesa SS. Epidemiology and risk factors for kidney cancer. Nat Rev Urol. 2010;7(5):245–57.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Sun M, Abdollah F, Bianchi M, Trinh QD, Jeldres C, Tian Z, et al. A stage-for-stage and grade-for-grade analysis of cancer-specific mortality rates in renal cell carcinoma according to age: a competing-risks regression analysis. Eur Urol. 2011;60(6):1152–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer. 2008;113(1):78–83.CrossRefGoogle Scholar
  7. 7.
    Kim SP, Alt AL, Weight CJ, Costello BA, Cheville JC, Lohse C, et al. Independent validation of the 2010 American Joint Committee on Cancer TNM classification for renal cell carcinoma: results from a large, single institution cohort. J Urol. 2011;185(6):2035–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Novara G, Ficarra V, Antonelli A, Artibani W, Bertini R, Carini M, et al. Validation of the 2009 TNM version in a large multi-institutional cohort of patients treated for renal cell carcinoma: are further improvements needed? Eur Urol. 2010;58(4):588–95.PubMedCrossRefGoogle Scholar
  9. 9.
    Bhindi B, Lohse CM, Mason RJ, Westerman ME, Cheville JC, Tollefson MK, et al. Are we using the best tumor size cut-points for renal cell carcinoma staging? Urology. 2017;109:121–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Cases C, Garcia-Zoghby L, Manzorro P, Valderrama-Canales FJ, Munoz M, Vidal M, et al. Anatomical variations of the renal arteries: cadaveric and radiologic study, review of the literature, and proposal of a new classification of clinical interest. Ann Anat. 2017;211:61–8.PubMedCrossRefGoogle Scholar
  11. 11.
    Baniel J, Foster RS, Donohue JP. Surgical anatomy of the lumbar vessels: implications for retroperitoneal surgery. J Urol. 1995;153(5):1422–5.PubMedCrossRefGoogle Scholar
  12. 12.
    Mathews R, Smith PA, Fishman EK, Marshall FF. Anomalies of the inferior vena cava and renal veins: embryologic and surgical considerations. Urology. 1999;53(5):873–80.PubMedCrossRefGoogle Scholar
  13. 13.
    Cohen HT, McGovern FJ. Renal-cell carcinoma. N Engl J Med. 2005;353(23):2477–90.PubMedCrossRefGoogle Scholar
  14. 14.
    Psutka SP, Boorjian SA, Thompson RH, Schmit GD, Schmitz JJ, Bower TC, et al. Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus. BJU Int. 2015;116(3):388–96.PubMedCrossRefGoogle Scholar
  15. 15.
    Psutka SP, Leibovich BC. Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma. Ther Adv Urol. 2015;7(4):216–29.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Ciancio G, Soloway M. Renal cell carcinoma invading the hepatic veins. Cancer. 2001;92(7):1836–42.PubMedCrossRefGoogle Scholar
  17. 17.
    Linehan WM, Pinto PA, Bratslavsky G, Pfaffenroth E, Merino M, Vocke CD, et al. Hereditary kidney cancer: unique opportunity for disease-based therapy. Cancer. 2009;115(10 Suppl):2252–61.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Reaume MN, Graham GE, Tomiak E, Kamel-Reid S, Jewett MA, Bjarnason GA, et al. Canadian guideline on genetic screening for hereditary renal cell cancers. Can Urol Assoc J. 2013;7(9–10):319–23.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Verine J, Pluvinage A, Bousquet G, Lehmann-Che J, de Bazelaire C, Soufir N, et al. Hereditary renal cancer syndromes: an update of a systematic review. Eur Urol. 2010;58(5):701–10.PubMedCrossRefGoogle Scholar
  20. 20.
    National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Kidney Cancer (Version 2.2017). Available from: https://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf.
  21. 21.
    Sheth S, Scatarige JC, Horton KM, Corl FM, Fishman EK. Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector CT and three-dimensional CT. Radiographics. 2001;21 Spec No:S237–54.PubMedCrossRefGoogle Scholar
  22. 22.
    Larcher A, Dell'Oglio P, Fossati N, Nini A, Muttin F, Suardi N, et al. When to perform preoperative chest computed tomography for renal cancer staging. BJU Int. 2017;120(4):490–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Kutikov A, Smaldone MC, Uzzo RG, Haifler M, Bratslavsky G, Leibovich BC. Renal mass biopsy: always, sometimes, or never? Eur Urol. 2016;70(3):403–6.CrossRefGoogle Scholar
  24. 24.
    Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol. 2003;170(6 Pt 1):2217–20.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Rini BI, McKiernan JM, Chang SS, Choueiri TK, Kenney PA, Landman J, et al. Kidney. In: Amin MB, editor. AJCC Cancer Staging Manual. 8th ed. Chicago: Springer; 2017. p. 739–48.Google Scholar
  26. 26.
    Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol. 1987;59(5):390–5.PubMedCrossRefGoogle Scholar
  27. 27.
    Novick AC, Streem SB, Pontes E. Stewart’s operative urology. 2nd ed. Philadelphia: Williams & Wilkins; 1989.Google Scholar
  28. 28.
    Hinman F. Atlas of urologic surgery. 2nd ed. Philadelphia: WB Saunders Co; 1998.Google Scholar
  29. 29.
    Robson CJ. Staging of renal cell carcinoma. Prog Clin Biol Res. 1982;100:439–45.PubMedGoogle Scholar
  30. 30.
    Pouliot F, Shuch B, Larochelle JC, Pantuck A, Belldegrun AS. Contemporary management of renal tumors with venous tumor thrombus. J Urol. 2010;184(3):833–41. quiz 1235PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Gettman MT, Boelter CW, Cheville JC, Zincke H, Bryant SC, Blute ML. Charlson co-morbidity index as a predictor of outcome after surgery for renal cell carcinoma with renal vein, vena cava or right atrium extension. J Urol. 2003;169(4):1282–6.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Kallman DA, King BF, Hattery RR, Charboneau JW, Ehman RL, Guthman DA, et al. Renal vein and inferior vena cava tumor thrombus in renal cell carcinoma: CT, US, MRI and venacavography. J Comput Assist Tomogr. 1992;16(2):240–7.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Oto A, Herts BR, Remer EM, Novick AC. Inferior vena cava tumor thrombus in renal cell carcinoma: staging by MR imaging and impact on surgical treatment. AJR Am J Roentgenol. 1998;171(6):1619–24.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Blute ML, Leibovich BC, Lohse CM, Cheville JC, Zincke H. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int. 2004;94(1):33–41.CrossRefGoogle Scholar
  35. 35.
    Goldfarb DA, Novick AC, Lorig R, Bretan PN, Montie JE, Pontes JE, et al. Magnetic resonance imaging for assessment of vena caval tumor thrombi: a comparative study with venacavography and computerized tomography scanning. J Urol. 1990;144(5):1100–3. discussion 3–4PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Lawrentschuk N, Gani J, Riordan R, Esler S, Bolton DM. Multidetector computed tomography vs magnetic resonance imaging for defining the upper limit of tumour thrombus in renal cell carcinoma: a study and review. BJU Int. 2005;96(3):291–5.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Guzzo TJ, Pierorazio PM, Schaeffer EM, Fishman EK, Allaf ME. The accuracy of multidetector computerized tomography for evaluating tumor thrombus in patients with renal cell carcinoma. J Urol. 2009;181(2):486–90. discussion 91PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Gershman B, Takahashi N, Moreira DM, Thompson RH, Boorjian SA, Lohse CM, et al. Radiographic size of retroperitoneal lymph nodes predicts pathological nodal involvement for patients with renal cell carcinoma: development of a risk prediction model. BJU Int. 2016;118(5):742–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Blute ML, Leibovich BC, Cheville JC, Lohse CM, Zincke H. A protocol for performing extended lymph node dissection using primary tumor pathological features for patients treated with radical nephrectomy for clear cell renal cell carcinoma. J Urol. 2004;172(2):465–9.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Crispen PL, Breau RH, Allmer C, Lohse CM, Cheville JC, Leibovich BC, et al. Lymph node dissection at the time of radical nephrectomy for high-risk clear cell renal cell carcinoma: indications and recommendations for surgical templates. Eur Urol. 2011;59(1):18–23.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Hutterer GC, Patard JJ, Perrotte P, Ionescu C, de La Taille A, Salomon L, et al. Patients with renal cell carcinoma nodal metastases can be accurately identified: external validation of a new nomogram. Int J Cancer. 2007;121(11):2556–61.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Capitanio U, Abdollah F, Matloob R, Suardi N, Castiglione F, Di Trapani E, et al. When to perform lymph node dissection in patients with renal cell carcinoma: a novel approach to the preoperative assessment of risk of lymph node invasion at surgery and of lymph node progression during follow-up. BJU Int. 2013;112(2):E59–66.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Schwartz MJ, Smith EB, Trost DW, Vaughan ED Jr. Renal artery embolization: clinical indications and experience from over 100 cases. BJU Int. 2007;99(4):881–6.CrossRefGoogle Scholar
  44. 44.
    Bakal CW, Cynamon J, Lakritz PS, Sprayregen S. Value of preoperative renal artery embolization in reducing blood transfusion requirements during nephrectomy for renal cell carcinoma. J Vasc Interv Radiol. 1993;4(6):727–31.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    May M, Brookman-Amissah S, Pflanz S, Roigas J, Hoschke B, Kendel F. Pre-operative renal arterial embolisation does not provide survival benefit in patients with radical nephrectomy for renal cell carcinoma. Br J Radiol. 2009;82(981):724–31.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Bergreen PW, Woodside J, Paster SB. Therapeutic renal infarction. J Urol. 1977;118(3):372–4.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Subramanian VS, Stephenson AJ, Goldfarb DA, Fergany AF, Novick AC, Krishnamurthi V. Utility of preoperative renal artery embolization for management of renal tumors with inferior vena caval thrombi. Urology. 2009;74(1):154–9.CrossRefGoogle Scholar
  48. 48.
    Woodruff DY, Van Veldhuizen P, Muehlebach G, Johnson P, Williamson T, Holzbeierlein JM. The perioperative management of an inferior vena caval tumor thrombus in patients with renal cell carcinoma. Urol Oncol. 2013;31(5):517–21.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Blute ML, Boorjian SA, Leibovich BC, Lohse CM, Frank I, Karnes RJ. Results of inferior vena caval interruption by greenfield filter, ligation or resection during radical nephrectomy and tumor thrombectomy. J Urol. 2007;178(2):440–5. discussion 4PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Cowey CL, Amin C, Pruthi RS, Wallen EM, Nielsen ME, Grigson G, et al. Neoadjuvant clinical trial with sorafenib for patients with stage II or higher renal cell carcinoma. J Clin Oncol. 2010;28(9):1502–7.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Powers MK, Sartor O, Lee BR. Neoadjuvant tyrosine kinase downstaging of T2 renal cell carcinoma in solitary kidney before robotic partial nephrectomy. J Endourol Case Rep. 2015;1(1):47–9.PubMedPubMedCentralCrossRefGoogle Scholar
  52. 52.
    Silberstein JL, Millard F, Mehrazin R, Kopp R, Bazzi W, DiBlasio CJ, et al. Feasibility and efficacy of neoadjuvant sunitinib before nephron-sparing surgery. BJU Int. 2010;106(9):1270–6.CrossRefGoogle Scholar
  53. 53.
    Shuch B, Riggs SB, LaRochelle JC, Kabbinavar FF, Avakian R, Pantuck AJ, et al. Neoadjuvant targeted therapy and advanced kidney cancer: observations and implications for a new treatment paradigm. BJU Int. 2008;102(6):692–6.CrossRefGoogle Scholar
  54. 54.
    Karakiewicz PI, Suardi N, Jeldres C, Audet P, Ghosn P, Patard JJ, et al. Neoadjuvant sutent induction therapy may effectively down-stage renal cell carcinoma atrial thrombi. Eur Urol. 2008;53(4):845–8.CrossRefGoogle Scholar
  55. 55.
    Di Silverio F, Sciarra A, Parente U, Andrea A, Von Heland M, Panebianco V, et al. Neoadjuvant therapy with sorafenib in advanced renal cell carcinoma with vena cava extension submitted to radical nephrectomy. Urol Int. 2008;80(4):451–3.CrossRefGoogle Scholar
  56. 56.
    Cost NG, Delacroix SE Jr, Sleeper JP, Smith PJ, Youssef RF, Chapin BF, et al. The impact of targeted molecular therapies on the level of renal cell carcinoma vena caval tumor thrombus. Eur Urol. 2011;59(6):912–8.CrossRefGoogle Scholar
  57. 57.
    Haas NB, Manola J, Uzzo RG, Flaherty KT, Wood CG, Kane C, et al. Adjuvant sunitinib or sorafenib for high-risk, non-metastatic renal-cell carcinoma (ECOG-ACRIN E2805): a double-blind, placebo-controlled, randomised, phase 3 trial. Lancet. 2016;387(10032):2008–16.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Haas NB, Manola J, Dutcher JP, Flaherty KT, Uzzo RG, Atkins MB, et al. Adjuvant treatment for high-risk clear cell renal Cancer: updated results of a high-risk subset of the ASSURE randomized trial. JAMA Oncol. 2017;3(9):1249–52.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Ravaud A, Motzer RJ, Pandha HS, George DJ, Pantuck AJ, Patel A, et al. Adjuvant sunitinib in high-risk renal-cell carcinoma after nephrectomy. N Engl J Med. 2016;375(23):2246–54.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Motzer RJ, Haas NB, Donskov F, Gross-Goupil M, Varlamov S, Kopyltsov E, et al. Randomized phase III trial of adjuvant pazopanib versus placebo after nephrectomy in patients with localized or locally advanced renal cell carcinoma. J Clin Oncol. 2017;35:3916.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Simmons MN, Kaouk J, Gill IS, Fergany A. Laparoscopic radical nephrectomy with hilar lymph node dissection in patients with advanced renal cell carcinoma. Urology. 2007;70(1):43–6.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Stewart GD, Ang WJ, Laird A, Tolley DA, Riddick AC, McNeill SA. The operative safety and oncological outcomes of laparoscopic nephrectomy for T3 renal cell cancer. BJU Int. 2012;110(6):884–90.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Stifelman MD, Handler T, Nieder AM, Del Pizzo J, Taneja S, Sosa RE, et al. Hand-assisted laparoscopy for large renal specimens: a multi-institutional study. Urology. 2003;61(1):78–82.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Jeong IG, Khandwala YS, Kim JH, Han DH, Li S, Wang Y, et al. Association of robotic-assisted vs laparoscopic radical nephrectomy with perioperative outcomes and health care costs, 2003 to 2015. JAMA. 2017;318(16):1561–8.PubMedPubMedCentralCrossRefGoogle Scholar
  65. 65.
    Yang DY, Monn MF, Bahler CD, Sundaram CP. Does robotic assistance confer an economic benefit during laparoscopic radical nephrectomy? J Urol. 2014;192(3):671–6.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Shao P, Li J, Qin C, Lv Q, Ju X, Li P, et al. Laparoscopic radical nephrectomy and inferior vena cava thrombectomy in the treatment of renal cell carcinoma. Eur Urol. 2015;68(1):115–22.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Chopra S, Simone G, Metcalfe C, de Castro Abreu AL, Nabhani J, Ferriero M, et al. Robot-assisted level II-III inferior vena cava tumor thrombectomy: step-by-step technique and 1-year outcomes. Eur Urol. 2017;72(2):267–74.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Seiler CM, Deckert A, Diener MK, Knaebel HP, Weigand MA, Victor N, et al. Midline versus transverse incision in major abdominal surgery: a randomized, double-blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg. 2009;249(6):913–20.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Vigneswaran Y, Poli E, Talamonti MS, Haggerty SP, Linn JG, Ujiki MB. Rectus abdominis atrophy after ventral abdominal incisions: midline versus chevron. Hernia. 2017;21:619.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Boorjian SA, Sengupta S, Blute ML. Renal cell carcinoma: vena caval involvement. BJU Int. 2007;99(5 Pt B):1239–44.PubMedCrossRefGoogle Scholar
  71. 71.
    Nason GJ, Aslam A, Giri SK. Predictive ability of preoperative CT scan in determining whether the adrenal gland is spared at radical nephrectomy. Curr Urol. 2016;9(3):143–7.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Weight CJ, Kim SP, Lohse CM, Cheville JC, Thompson RH, Boorjian SA, et al. Routine adrenalectomy in patients with locally advanced renal cell cancer does not offer oncologic benefit and places a significant portion of patients at risk for an asynchronous metastasis in a solitary adrenal gland. Eur Urol. 2011;60(3):458–64.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    O'Malley RL, Godoy G, Kanofsky JA, Taneja SS. The necessity of adrenalectomy at the time of radical nephrectomy: a systematic review. J Urol. 2009;181(5):2009–17.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Yap SA, Alibhai SM, Abouassaly R, Timilshina N, Margel D, Finelli A. Ipsilateral adrenalectomy at the time of radical nephrectomy impacts overall survival. BJU Int. 2013;111(3 Pt B):E54–8.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Shuch B, Crispen PL, Leibovich BC, Larochelle JC, Pouliot F, Pantuck AJ, et al. Cardiopulmonary bypass and renal cell carcinoma with level IV tumour thrombus: can deep hypothermic circulatory arrest limit perioperative mortality? BJU Int. 2011;107(5):724–8.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Ciancio G, Soloway MS. Renal cell carcinoma with tumor thrombus extending above diaphragm: avoiding cardiopulmonary bypass. Urology. 2005;66(2):266–70.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Hyams ES, Pierorazio PM, Shah A, Lum YW, Black J, Allaf ME. Graft reconstruction of inferior vena cava for renal cell carcinoma stage pT3b or greater. Urology. 2011;78(4):838–43.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Karmali RJ, Suami H, Wood CG, Karam JA. Lymphatic drainage in renal cell carcinoma: back to the basics. BJU Int. 2014;114(6):806–17.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Assouad J, Riquet M, Foucault C, Hidden G, Delmas V. Renal lymphatic drainage and thoracic duct connections: implications for cancer spread. Lymphology. 2006;39(1):26–32.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Capitanio U, Leibovich BC. The rationale and the role of lymph node dissection in renal cell carcinoma. World J Urol. 2017;35(4):497–506.PubMedCrossRefGoogle Scholar
  81. 81.
    Blom JH, van Poppel H, Marechal JM, Jacqmin D, Schroder FH, de Prijck L, et al. Radical nephrectomy with and without lymph-node dissection: final results of European Organization for Research and Treatment of Cancer (EORTC) randomized phase 3 trial 30881. Eur Urol. 2009;55(1):28–34.PubMedCrossRefGoogle Scholar
  82. 82.
    Capitanio U, Suardi N, Matloob R, Roscigno M, Abdollah F, Di Trapani E, et al. Extent of lymph node dissection at nephrectomy affects cancer-specific survival and metastatic progression in specific sub-categories of patients with renal cell carcinoma (RCC). BJU Int. 2014;114(2):210–5.PubMedCrossRefGoogle Scholar
  83. 83.
    Schafhauser W, Ebert A, Brod J, Petsch S, Schrott KM. Lymph node involvement in renal cell carcinoma and survival chance by systematic lymphadenectomy. Anticancer Res. 1999;19(2C):1573–8.PubMedGoogle Scholar
  84. 84.
    Gershman B, Thompson RH, Moreira DM, Boorjian SA, Tollefson MK, Lohse CM, et al. Radical nephrectomy with or without lymph node dissection for nonmetastatic renal cell carcinoma: a propensity score-based analysis. Eur Urol. 2017;71(4):560–7.PubMedCrossRefGoogle Scholar
  85. 85.
    Feuerstein MA, Kent M, Bazzi WM, Bernstein M, Russo P. Analysis of lymph node dissection in patients with >/=7-cm renal tumors. World J Urol. 2014;32(6):1531–6.PubMedPubMedCentralCrossRefGoogle Scholar
  86. 86.
    Gershman B, Moreira DM, Thompson RH, Boorjian SA, Lohse CM, Costello BA, et al. Renal cell carcinoma with isolated lymph node involvement: long-term natural history and predictors of oncologic outcomes following surgical resection. Eur Urol. 2017;72:300.PubMedCrossRefGoogle Scholar
  87. 87.
    Whitson JM, Harris CR, Reese AC, Meng MV. Lymphadenectomy improves survival of patients with renal cell carcinoma and nodal metastases. J Urol. 2011;185(5):1615–20.PubMedCrossRefGoogle Scholar
  88. 88.
    Sun M, Trinh QD, Bianchi M, Hansen J, Abdollah F, Tian Z, et al. Extent of lymphadenectomy does not improve the survival of patients with renal cell carcinoma and nodal metastases: biases associated with the handling of missing data. BJU Int. 2014;113(1):36–42.PubMedCrossRefGoogle Scholar
  89. 89.
    Gershman B, Thompson RH, Moreira DM, Boorjian SA, Lohse CM, Costello BA, et al. Lymph node dissection is not associated with improved survival among patients undergoing cytoreductive nephrectomy for metastatic renal cell carcinoma: a propensity score based analysis. J Urol. 2017;197(3 Pt 1):574–9.PubMedCrossRefGoogle Scholar
  90. 90.
    Joyce DD, Psutka SP, Groeschl RT, Thompson RH, Boorjian SA, Cheville JC, et al. Complications and outcomes associated with surgical management of renal cell carcinoma involving the liver: a matched cohort study. Urology. 2017;99:155–61.PubMedCrossRefGoogle Scholar
  91. 91.
    Borregales LD, Kim DY, Staller AL, Qiao W, Thomas AZ, Adibi M, et al. Prognosticators and outcomes of patients with renal cell carcinoma and adjacent organ invasion treated with radical nephrectomy. Urol Oncol. 2016;34(5):237.e19–26.CrossRefGoogle Scholar
  92. 92.
    Sood A, Abdollah F, Sammon JD, Kapoor V, Rogers CG, Jeong W, et al. An evaluation of the timing of surgical complications following nephrectomy: data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). World J Urol. 2015;33(12):2031–8.PubMedCrossRefGoogle Scholar
  93. 93.
    Abel EJ, Thompson RH, Margulis V, Heckman JE, Merril MM, Darwish OM, et al. Perioperative outcomes following surgical resection of renal cell carcinoma with inferior vena cava thrombus extending above the hepatic veins: a contemporary multicenter experience. Eur Urol. 2014;66(3):584–92.CrossRefGoogle Scholar
  94. 94.
    Toren P, Abouassaly R, Timilshina N, Kulkarni G, Alibhai S, Finelli A. Results of a national population-based study of outcomes of surgery for renal tumors associated with inferior vena cava thrombus. Urology. 2013;82(3):572–7.PubMedCrossRefGoogle Scholar
  95. 95.
    Hicks CW, Glebova NO, Piazza KM, Orion K, Pierorazio PM, Lum YW, et al. Risk of venous thromboembolic events following inferior vena cava resection and reconstruction. J Vasc Surg. 2016;63(4):1004–10.PubMedCrossRefGoogle Scholar
  96. 96.
    Meskawi M, Sun M, Trinh QD, Bianchi M, Hansen J, Tian Z, et al. A review of integrated staging systems for renal cell carcinoma. Eur Urol. 2012;62(2):303–14.PubMedCrossRefGoogle Scholar
  97. 97.
    Lane BR, Kattan MW. Prognostic models and algorithms in renal cell carcinoma. Urol Clin North Am. 2008;35(4):613–25. viiPubMedCrossRefGoogle Scholar
  98. 98.
    Reese AC, Whitson JM, Meng MV. Natural history of untreated renal cell carcinoma with venous tumor thrombus. Urol Oncol. 2013;31(7):1305–9.PubMedCrossRefGoogle Scholar
  99. 99.
    Haferkamp A, Bastian PJ, Jakobi H, Pritsch M, Pfitzenmaier J, Albers P, et al. Renal cell carcinoma with tumor thrombus extension into the vena cava: prospective long-term followup. J Urol. 2007;177(5):1703–8.PubMedCrossRefGoogle Scholar
  100. 100.
    Karnes RJ, Blute ML. Surgery insight: management of renal cell carcinoma with associated inferior vena cava thrombus. Nat Clin Pract Urol. 2008;5(6):329–39.PubMedCrossRefGoogle Scholar
  101. 101.
    Lambert EH, Pierorazio PM, Shabsigh A, Olsson CA, Benson MC, McKiernan JM. Prognostic risk stratification and clinical outcomes in patients undergoing surgical treatment for renal cell carcinoma with vascular tumor thrombus. Urology. 2007;69(6):1054–8.PubMedCrossRefGoogle Scholar
  102. 102.
    Klatte T, Pantuck AJ, Riggs SB, Kleid MD, Shuch B, Zomorodian N, et al. Prognostic factors for renal cell carcinoma with tumor thrombus extension. J Urol. 2007;178(4 Pt 1):1189–95. discussion 95PubMedCrossRefGoogle Scholar
  103. 103.
    Sweeney P, Wood CG, Pisters LL, Slaton JW, Vaporciyan A, Munsell M, et al. Surgical management of renal cell carcinoma associated with complex inferior vena caval thrombi. Urol Oncol. 2003;21(5):327–33.PubMedCrossRefGoogle Scholar
  104. 104.
    Parker WP, Cheville JC, Frank I, Zaid HB, Lohse CM, Boorjian SA, et al. Application of the Stage, Size, Grade, and Necrosis (SSIGN) Score for clear cell renal cell carcinoma in contemporary patients. Eur Urol. 2017;71(4):665–73.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Leibovich BC, Lohse CM, Crispen PL, Boorjian SA, Thompson RH, Blute ML, et al. Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urol. 2010;183(4):1309–15.PubMedCrossRefGoogle Scholar
  106. 106.
    Zhang BY, Thompson RH, Lohse CM, Leibovich BC, Boorjian SA, Cheville JC, et al. A novel prognostic model for patients with sarcomatoid renal cell carcinoma. BJU Int. 2015;115(3):405–11.PubMedCrossRefGoogle Scholar
  107. 107.
    Zhang BY, Cheville JC, Thompson RH, Lohse CM, Boorjian SA, Leibovich BC, et al. Impact of rhabdoid differentiation on prognosis for patients with grade 4 renal cell carcinoma. Eur Urol. 2015;68(1):5–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyMayo ClinicRochesterUSA
  2. 2.Southern Alberta Institute of UrologyCalgaryCanada

Personalised recommendations