Resection of the inferior vena cava or intraluminal vena caval tumor thrombectomy during retroperitoneal lymph node dissection for metastatic germ cell cancer

Indications and results

J. P. Donohue, J. A. Thornhill, Richard Foster, R. G. Rowland, Richard Bihrle

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

A total of 42 patients underwent inferior vena caval resection (40) or intraluminal tumor thrombectomy (2) during retroperitoneal lymph node dissection for bulky abdominal metastatic nonseminomatous germ cell cancer (7% of all post-chemotherapy retroperitoneal lymph node dissection cases). The 3 indications for vena caval resection included tumor clearance (38%), vena caval scar occlusion (14%) and vena caval tumor thrombus (48%). En bloc vena caval resection to achieve tumor clearance was justified by subsequent nodal pathology (cancer in 63% of the specimens and teratoma in 31%). Vena caval resection in the presence of scar occlusion was de facto required by virtue of its incorporation in the specimen. Vena caval resection or thrombectomy is indicated for intraluminal tumor thrombus because thrombus pathology (cancer 35%, teratoma 45% and fibrosis 20%) reflected nodal pathology in 71% of the patients with cancer, 78% with teratoma and 100% with fibrosis. The complications of vena caval resection were generally transitory. The 71% survival rate justifies this intensive surgical approach because these patients had exhausted all chemotherapy options.

Original languageEnglish
Pages (from-to)346-349
Number of pages4
JournalJournal of Urology
Volume146
Issue number2
StatePublished - 1991

Fingerprint

Thrombectomy
Venae Cavae
Germ Cell and Embryonal Neoplasms
Inferior Vena Cava
Lymph Node Excision
Neoplasms
Teratoma
Thrombosis
Pathology
Cicatrix
Fibrosis
Drug Therapy
Survival Rate

Keywords

  • Carcinoma
  • Lymph node excision
  • Testis
  • Thrombosis
  • Vena cava, inferior

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Resection of the inferior vena cava or intraluminal vena caval tumor thrombectomy during retroperitoneal lymph node dissection for metastatic germ cell cancer: Indications and results",
abstract = "A total of 42 patients underwent inferior vena caval resection (40) or intraluminal tumor thrombectomy (2) during retroperitoneal lymph node dissection for bulky abdominal metastatic nonseminomatous germ cell cancer (7{\%} of all post-chemotherapy retroperitoneal lymph node dissection cases). The 3 indications for vena caval resection included tumor clearance (38{\%}), vena caval scar occlusion (14{\%}) and vena caval tumor thrombus (48{\%}). En bloc vena caval resection to achieve tumor clearance was justified by subsequent nodal pathology (cancer in 63{\%} of the specimens and teratoma in 31{\%}). Vena caval resection in the presence of scar occlusion was de facto required by virtue of its incorporation in the specimen. Vena caval resection or thrombectomy is indicated for intraluminal tumor thrombus because thrombus pathology (cancer 35{\%}, teratoma 45{\%} and fibrosis 20{\%}) reflected nodal pathology in 71{\%} of the patients with cancer, 78{\%} with teratoma and 100{\%} with fibrosis. The complications of vena caval resection were generally transitory. The 71{\%} survival rate justifies this intensive surgical approach because these patients had exhausted all chemotherapy options.",
keywords = "Carcinoma, Lymph node excision, Testis, Thrombosis, Vena cava, inferior",
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AU - Thornhill, J. A.

AU - Foster, Richard

AU - Rowland, R. G.

AU - Bihrle, Richard

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N2 - A total of 42 patients underwent inferior vena caval resection (40) or intraluminal tumor thrombectomy (2) during retroperitoneal lymph node dissection for bulky abdominal metastatic nonseminomatous germ cell cancer (7% of all post-chemotherapy retroperitoneal lymph node dissection cases). The 3 indications for vena caval resection included tumor clearance (38%), vena caval scar occlusion (14%) and vena caval tumor thrombus (48%). En bloc vena caval resection to achieve tumor clearance was justified by subsequent nodal pathology (cancer in 63% of the specimens and teratoma in 31%). Vena caval resection in the presence of scar occlusion was de facto required by virtue of its incorporation in the specimen. Vena caval resection or thrombectomy is indicated for intraluminal tumor thrombus because thrombus pathology (cancer 35%, teratoma 45% and fibrosis 20%) reflected nodal pathology in 71% of the patients with cancer, 78% with teratoma and 100% with fibrosis. The complications of vena caval resection were generally transitory. The 71% survival rate justifies this intensive surgical approach because these patients had exhausted all chemotherapy options.

AB - A total of 42 patients underwent inferior vena caval resection (40) or intraluminal tumor thrombectomy (2) during retroperitoneal lymph node dissection for bulky abdominal metastatic nonseminomatous germ cell cancer (7% of all post-chemotherapy retroperitoneal lymph node dissection cases). The 3 indications for vena caval resection included tumor clearance (38%), vena caval scar occlusion (14%) and vena caval tumor thrombus (48%). En bloc vena caval resection to achieve tumor clearance was justified by subsequent nodal pathology (cancer in 63% of the specimens and teratoma in 31%). Vena caval resection in the presence of scar occlusion was de facto required by virtue of its incorporation in the specimen. Vena caval resection or thrombectomy is indicated for intraluminal tumor thrombus because thrombus pathology (cancer 35%, teratoma 45% and fibrosis 20%) reflected nodal pathology in 71% of the patients with cancer, 78% with teratoma and 100% with fibrosis. The complications of vena caval resection were generally transitory. The 71% survival rate justifies this intensive surgical approach because these patients had exhausted all chemotherapy options.

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KW - Lymph node excision

KW - Testis

KW - Thrombosis

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