Multidisciplinary surgical approach to the treatment of renal cell cancer stage T3c

116 Multidisciplinary surgical approach to the treatment of renal cell cancer stage T3c Ferencak V.1, Kulis T.1, Hudolin T.1, Topalovic Grkovic M.1, Krhen I.1, Biocina B.2, Kastelan Z.1 1 University Hospital Center Zagreb and University of Zagreb, School of Medicine, Dept. of Urology, Zagreb, Croatia, 2University Hospital Center Zagreb and University of Zagreb, School of Medicine, Dept. of Cardiac Surgery, Zagreb, Croatia INTRODUCTION & OBJECTIVES: Renal malignancies account for 3% of all malignancies in humans. Histologically the most common type are adenocarcinomas and their incidence is increasing with age. Due to the mild and varied symptomatology, and its insidious way of metastasis, renal cell carcinoma it is considered to be the greatest imitator among tumors. Renal cell cancer primarily metastasizes via lymphatic and hematogenic pathways, but also through the creation of tumor thrombus that spreads into the renal vein then into inferior vena cava (IVC) and from there into the right atrium. Aim of this paper is to present our case series documenting our experience and results with surgical management of T3c renal cell cancer (RCC). MATERIAL & METHODS: From database of patients operated in our hospital we have identified patients who were treated for T3c RCC. We performed analysis of patients’ medical records. RESULTS: In the period from 2008 to 2014, at the Department of Urology, University Hospital Center Zagreb, 9 patients were treated for T3c RCC. Average age of patients was 63.6 (42-77) years. All operations were performed in cooperation with cardiac surgeons. Surgical procedures were performed in hypothermia using extracorporeal circulation. In all cases pathology report was clear cell renal cancer. Postoperatively, two patients have had pulmonary embolism and one patient have had partial kidney embolism and infrarenal aortic dissection that was treated conservatively. During average follow up period of 27.7 (12-48) months 4 patients have died (two because of RCC). One patient was lost to follow up. CONCLUSIONS: Surgical treatment of advanced RCC involving the IVC is feasible with acceptable morbidity and mortality. Our series is comparable to other reported series. Long-term survival can be expected in non-metastatic patients. These cases benefit from a multidisciplinary surgical approach. Eur Urol Suppl 2015; 14(6): e1278