ESSENTIAL DIAGNOSTICS AND SURGERY IN RENA L-CELL CARCINOMA WITH VENA-CAVAL INVOLVEMENT

Venous involvement in renal cell carcinoma (RCC) represents an advance d state of disease. Nonetheless, its influence on survival is rather s econdary compared with that of local tumor growth, grading and metasta sis. Since conservative treatment in advanced RCC is mainly ineffectiv e, surgical management offers the most premising approach for potentia l cure. without metastasis, seem to benefit from an aggressive surgica l intervention. The surgical technique itself is determined by the ven a caval extent of the tumor thrombus. Preferably, noninvasive imaging techniques should provide information about metastasis and the extent of the tumor thrombus. Diagnostic efforts should be adapted to therape utic feasibility and prognosis in every individual patient in order to avoid fatiguing and costly over-examination. The standards requested above can be realized by use of modern sonographic and computed-tomegr aphic imaging techniques or by magnetic resonance imaging alone. Thus, nowadays, the essential diagnostics in RCC with vena caval involvemen t may dispense with angiographic examinations.