Stellenwert multimodaler Therapiekonzepte beim Nierenzellkarzinom mit Vena Cava Thrombus

The renal cell carcinoma is the third leading cause of urology cancer between 60 and 70. Men are more affected than women. 4-10% of patients with renal cell carcinoma develop a tumor thrombus of the vena cava. 30% of the patients already have metastasis cancer at the time of the operation. The aim of this study, performed between 1998 and 2003 at the Phillips University Marburg, was to review the effect of different therapy concepts and to give a statement about prognostic factors. The results of this study show that patients with metastatic renal cell carcinoma have a decreased expectancy of life. Literary confirms this result. The immune/chemotherapy, which was also reviewed in this study, did not show similar clear results. The best results, but still not significantly better, are achievable by a combination of the immune/chemotherapy and a nephrectomy. All other immune/chemotherapies have no positive effects on the life expectancy of the patients, does not matter if it is the first or second line therapy. An additional focus of this study was the prognostic significance of the thrombus level on the life expectancy. Different cases are discussed in literary, in which extent a low thrombus level correlates to a better prognosis for the patient. As a result of this study, a low thrombus level does not lead into a significant increased life expectancy of metastatic or not metastatic renal cell carcinoma patients.