Carcinoma de Células Renais com Envolvimento Venoso

introduction: renal cell carcinoma (rcc) accounts for 3% of adult carcinomas. it is one of the most deadly urological cancers with disease specific mortality of 40%. venous wall invasion or tumor thrombus is seen in 4% to 10% of patients (= t3b), with 5 years survival from 40% to 60%. the only curative treatment is tumor thrombus and kidney en bloc removal. materials and methods: all the clinical, radiological and pathological data of the patients submitted to radical nephrectomy at our institution through 2008 and 2009 was reviewed. results: we found venous involvement in seven of the 69 patients (10,1%). average age was 58 years (32-72); six patients (85,7%) had renal vein invasion; four (57,1%) had renal vein thrombus and three (42,9%) had cava vein thrombus (two at level ii and one at level iii). three were submitted to cavotomy with no complications. one was lost to follow-up; two died on early post-op (three to seven days); one died due to systemic disease progression; the other three have disease progression. conclusions: rcc with vena cava involvement has a poor natural history, but this can be dramatically changed with an aggressive and complete surgical attitude. for that means, multidisciplinary teams are mandatory.