Impact of Neoadjuvant Sunitinib Treatment on Tumour Thrombi in the Inferior Vena Cava in Metastatic Renal Cell Carcinoma.

The authors report cases of metastatic renal cell carcinoma with level III-IV tumour thrombi in the inferior vena cava (IVC). Cases were treated with three courses of neoadjuvant sunitinib to reduce the thrombus level before surgery. Nephrectomy and tumour thrombectomy were performed, and sunitinib treatment continued after the operation. Cases 1 and 3 showed regression of lung metastases, but the size of the primary renal tumour and thrombus remained the same. The progression-free survival of the cases was 35 months and 24 months, respectively. In case 2, the primary renal tumour, metastases and thrombus showed regression. The upper limit of the thrombus decreased by 3 cm. In this case, the progression-free survival was 15 months, and the cancer-specific survival was 18 months. The neoadjuvant sunitinib treatment had a limited effect on downsizing the extent of tumour thrombi in the IVC. [ABSTRACT FROM AUTHOR]