<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1646-706X</journal-id>
<journal-title><![CDATA[Angiologia e Cirurgia Vascular]]></journal-title>
<abbrev-journal-title><![CDATA[Angiol Cir Vasc]]></abbrev-journal-title>
<issn>1646-706X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Angiologia e Cirurgia Vascular]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1646-706X2022000300172</article-id>
<article-id pub-id-type="doi">10.48750/acv.427</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Clinical outcomes after vena cava thrombectomy for renal cell carcinoma with venous extension - institutional experience]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pais]]></surname>
<given-names><![CDATA[Fábio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morais]]></surname>
<given-names><![CDATA[José Aragão de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quintas]]></surname>
<given-names><![CDATA[Anita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Rita Soares]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Catarino]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Correia]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bento]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Frederico Bastos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Maria Emília]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário de Lisboa Central Hospital de Santa Marta Serviço de Angiologia e Cirurgia Vascular]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Nova de Lisboa NOVA Medical School | Faculdade de Ciências Médicas ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>18</volume>
<numero>3</numero>
<fpage>172</fpage>
<lpage>175</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S1646-706X2022000300172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S1646-706X2022000300172&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S1646-706X2022000300172&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Renal cell carcinoma (RCC) frequently progress to involve the inferior vena cava (IVC) and even the right atrium (RA). Nephrectomy and eradication of the tumour thrombus, can extend survival and prevent symptoms of venous congestion. The authors evaluated the institutional experience of a tertiary center in the surgical management of RCC patients with tumour thrombi invading the IVC.  Methods:  Retrospective analysis of a single-center consecutive serie of patients with RCC and IVC tumor thrombi treated with surgery in our department between 2012 and 2021 was carried out. Demographic data, diagnostic and procedural characteristics, clinical outcomes and survival analysis were examined.  Results:  Of the included 18 patients, 33% (n=6) had smoking history, 78% (n=14) hypertension, 33% (n=6) diabetes and dyslipidaemia. Mean tumour size was 8.78±2.47cm (3-12cm), and 67% (n=12) of the cases were renal clear cell adenocarcinoma. On the basis of the Neves classification for IVC thrombus extension, 39% (n=7) of the patients had level I; 28% (n=5) level II; 17% (n=3) level III and 17% (n=3) level IV. The majority underwent radical nephrectomy, with cavotomy and vena cava thrombus removal followed by lateral venorrhaphy of the vena cava (89%,n=16). In one patient an infra-renal IVC ligation was performed and, in another patient, an IVC interposition with PTFE and a protesic-renal bypass were performed. In level IV, combined open sternotomy and cardiac bypass for RA thrombus control were necessary. Mean total operative time was 3h4min±1h19min and median intraoperative blood loss was 600ml requiring a median blood cells transfusion of 3.5units (0,16) during the hospital stay. Median ICU days was 2 days (0,14) and median hospital stay was 8 days (4,61). The mean preoperative serum creatinine was 1.23+0.38 mg/dL. After surgery, there was a mean decrease of serum creatinine of 0.001 mg/dL (p=.991) (paired T test), confirming the absence of renal impairment. Only one patient required reintervention in the post-operative course for splenectomy. Post-operative complications included one case of pulmonary embolism, pneumonia, acute coronary syndrome and two cases of temporary acute renal lesion. There was no 30-day mortality. Five patients underwent adjuvant chemotherapy. Median follow-up time was 19.5 months (6-46.2 months). The four-year overall survival rate was of 52.4% (figure 1).  Conclusion:  For advanced RCC with tumour thrombus extension into the IVC, despite the expected poor prognosis, nephrectomy and eradication of the entire tumour thrombus, has low morbidity and can prolong patient survival, in line with the presented results.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Renal cell carcinoma]]></kwd>
<kwd lng="en"><![CDATA[Inferior vena cava]]></kwd>
<kwd lng="en"><![CDATA[Venous thrombectomy]]></kwd>
<kwd lng="en"><![CDATA[Oncovascular surgery]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jemal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Siegel]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ward]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Hao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Xu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Thun]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cancer statistics, 2009]]></article-title>
<source><![CDATA[CA Cancer J Clin]]></source>
<year>2009</year>
<volume>59</volume>
<page-range>225-49</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rini]]></surname>
<given-names><![CDATA[BI]]></given-names>
</name>
<name>
<surname><![CDATA[Campbell]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
<name>
<surname><![CDATA[Escudier]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Renal cell carcinoma]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2009</year>
<volume>373</volume>
<page-range>1119-32</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marshall]]></surname>
<given-names><![CDATA[VF]]></given-names>
</name>
<name>
<surname><![CDATA[Middleton]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<name>
<surname><![CDATA[Holswade]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Goldsmith]]></surname>
<given-names><![CDATA[EI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgery for renal cell carcinoma in the vena cava]]></article-title>
<source><![CDATA[J Urol]]></source>
<year>1970</year>
<volume>103</volume>
<page-range>414-20</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Helfand]]></surname>
<given-names><![CDATA[BT]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[ND]]></given-names>
</name>
<name>
<surname><![CDATA[Kozlowski]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Eskandari]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vena Cava Thrombectomy and Primary Repair After Radical Nephrectomy for Renal Cell Carcinoma Single-Center Experience]]></article-title>
<source><![CDATA[Ann Vas Surg]]></source>
<year>2011</year>
<volume>25</volume>
<page-range>39-43</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neves]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Zincke]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical treatment of renal cancer with vena cava extension]]></article-title>
<source><![CDATA[Br J Urol]]></source>
<year>1987</year>
<volume>59</volume>
<page-range>390-5</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yazici]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Inci]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Bilen]]></surname>
<given-names><![CDATA[CY]]></given-names>
</name>
<name>
<surname><![CDATA[Gudeloglu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Akdogan]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ertoy]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Renal cell carcinoma with inferior vena cava thrombus the Hacettepe experience]]></article-title>
<source><![CDATA[Urol Oncol]]></source>
<year>2010</year>
<volume>28</volume>
<page-range>603-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Glazer]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Novick]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term follow-up after surgical treatment for renal cell carcinoma extending into the right atrium]]></article-title>
<source><![CDATA[J Urol]]></source>
<year>1996</year>
<volume>155</volume>
<page-range>448-50</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lubahn]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Sagalowsky]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenbaum]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Dikmen]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bhojani]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Paul]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Contemporary techniques and safety of cardiovascular procedures in the surgical management of renal cell carcinoma with tumor thrombus]]></article-title>
<source><![CDATA[J Thorac Cardiovasc Surg]]></source>
<year>2006</year>
<volume>131</volume>
<page-range>1289-95</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moinzadeh]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Libertino]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prognostic significance of tumor thrombus level in patients with renal cell carcinoma and venous tumor thrombus extension]]></article-title>
<source><![CDATA[Is all T3b the same?. J Urol]]></source>
<year>2004</year>
<volume>171</volume>
<page-range>598-601</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Skinner]]></surname>
<given-names><![CDATA[DG]]></given-names>
</name>
<name>
<surname><![CDATA[Pritchett]]></surname>
<given-names><![CDATA[TR]]></given-names>
</name>
<name>
<surname><![CDATA[Lieskovsky]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Boyd]]></surname>
<given-names><![CDATA[SD]]></given-names>
</name>
<name>
<surname><![CDATA[Stiles]]></surname>
<given-names><![CDATA[QR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Vena caval involvement by renal cell carcinoma Surgical resection provides meaningful long-term survival]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>1989</year>
<volume>210</volume>
<page-range>387-94</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ciancio]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Livingstone]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Soloway]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical management of renal cell carcinoma with tumor thrombus in the renal and inferior vena cava the University of Miami experience in using liver transplantation techniques]]></article-title>
<source><![CDATA[Eur Urol]]></source>
<year>2007</year>
<volume>51</volume>
<page-range>988-95</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parra]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Drouin]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hupertan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Comperat]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Bitker]]></surname>
<given-names><![CDATA[MO]]></given-names>
</name>
<name>
<surname><![CDATA[Rouprêt]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Oncological outcomes in patients undergoing radical nephrectomy and vena ca a thrombectomy for renal cell carcinoma with venous extension a single-centre experience]]></article-title>
<source><![CDATA[Eur J Surg Oncol]]></source>
<year>2011</year>
<volume>37</volume>
<page-range>422-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[S]]></surname>
<given-names><![CDATA[Kalaycioglu]]></given-names>
</name>
<name>
<surname><![CDATA[V]]></surname>
<given-names><![CDATA[Sinci]]></given-names>
</name>
<name>
<surname><![CDATA[H]]></surname>
<given-names><![CDATA[Aydin]]></given-names>
</name>
<name>
<surname><![CDATA[H]]></surname>
<given-names><![CDATA[Soncul]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cardiopulmonary bypass tecnhique for treatment of renal cell carcinoma extending into the vena cava]]></article-title>
<source><![CDATA[Ann Thorac Cardiovasc Surg]]></source>
<year>1999</year>
<volume>5</volume>
<page-range>419-21</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
