Surgical management of tumor thrombus into the right atrium

Abstract

Renal cell carcinoma represents 3% of solid tumors. In 4-10% of patients, venous tumor thrombosis is present, and 1% reaches the right atrium. Other tumors can be associated with tumor thrombosis. The natural history of venous tumor thrombosis implies a mean survival of 5 months. Between 2001 and 2021, 4 patients underwent resection of tumor thrombi into the right atrium, requiring cardiopulmonary bypass. None of the patients died within 30 days postoperatively. Mean follow-up time was 30.9 months (2.4- 96.1). Two patients are still alive and two died due to disease progression. Died patient’s follow-up was 7.5 and 17.4 months, surpassing life expectancy of those without surgery. We present a series of patients who underwent lumpectomy and IVC thrombectomy. IVC tumor thrombosis has an ominous prognosis, however surgical treatment has an important role by improving the survival of these patients. The multidisciplinary approach is necessary to obtain good postoperative results.

Keywords: Cardiopulmonary Bypass, Tumor Thrombus, Right Atrium