Inferior vena cava involvement in renal cell carcinoma: comparison of survival rates between patients with thrombus and infiltration.

Objective: In 4-10% of cases of renal cell carcinoma (RCC), involvement of the inferior vena cava (IVC) is present. IVC involvement may be due to either a pure thrombus or tumor extension. This study indicates that there is no significant difference in survival rates between patients with thrombus and those with infiltration of the IVC.
Material and Methods: The records of 84 patients who presented to our institution with RCC and IVC involvement and received surgical treatment between July 1973 and June 2006 were examined. The postoperative observation period was 120 months. Statistical analysis was performed using the Kaplan-Meier method and the log-rank test.
Results: Sixty-one patients demonstrated thrombus involvement of the IVC, while the remaining 23 exhibited infiltration. Over the observation period, an average survival time of 64.0 months was observed. The median survival time was 35.2 months. No significant difference in survival rates was observed between patients with thrombus and those with malignant infiltration of the IVC.
Conclusions: It is stated in the contemporary literature that IVC infiltration is an important prognostic factor in cases of RCC. This study indicates that there is no significant difference in survival rates between patients with thrombus and those with infiltration of the IVC. Lymph node metastases and undifferentiated RCC remain the only important prognostic factors that have a significant influence on the general survival of a patient.