Survival of patients with renal cell carcinoma invading the inferior vena cava.

Renal cell carcinoma with extension of tumor thrombus into the vena cava occurs in 5% to 10% of patients diagnosed. It is important to determine the extent of the thrombus to plan the operative approach. As long as there is no evidence of metastatic disease to viscera or bones or involvement of the lymph nodes, radical nephrectomy with removal of the tumor thrombus remains the best treatment for patients and provides the best opportunity for long-term survival. In properly selected patients, extended operation offers good long-term survival as observed in patients treated at the Lahey-Hitchcock Clinic, where a demonstrated 5-year survival of 64% and a 10-year survival of 57% was achieved.