Update on surgical management of renal cell carcinoma with venous extension.

Intravenous extension of renal cell carcinoma remains one of the most intense debate topics in urologic oncology. In the absence of effective alternative treatment, complete surgical removal of the primary tumor with its extension along the vena cava is the only hope for a potential cure. For this reason, an aggressive approach has been established as the mainstay of treatment. Recent advances in the understanding of the biology of intravascular tumor invasion and the considerable progress in the fields of diagnosis and treatment of this entity, with innovative surgical and systemic strategies, have completely redefined the management of these patients. A PubMed-MEDLINE search was conducted to identify relevant articles on the preoperative assessment and surgical management of renal cell carcinoma with intravenous tumor extension to provide updated knowledge on this always challenging topic.