DOI: 10.29188/2222-8543-2026-19-2-82-90
For citation:
Gritskevich A.A., Monakov D.M., Baitman T.P., Oganayn V.A., Miroshkina I.V., Borukaev A.Yu., Karelskaya N.A., Kalinin D.V., Parkhomenko D.A., Revishvili A.Sh. Surgical treatment of patients with venous tumor thrombi. Experimental and Clinical Urology. 2026;19(2):82-90; https://doi.org/10.29188/2222-8543-2026-19-2-82-90
Gritskevich A.A., Monakov D.M., Baitman T.P., Oganayn V.A., Miroshkina I.V., Borukaev A.Yu., Karelskaya N.A., Kalinin D.V., Parkhomenko D.A., Revishvili A.Sh.
Information about authors:
- Gritskevich A.A. – Dr. Sci., Professor of the Russian Academy of Sciences, Head of the Depart¬ment of Oncourology and Urology at the A.V. Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation; Professor of the Department of Urology and Operative Nephrology with a course in Oncourology at the RUDN University, Moscow, Russia; RSCI Author ID: 816947, https://orcid.org/0000-0002-5160-925Х
- Monakov D.M. – PhD, Senior Researcher at the Department of Oncourology and Urology at the A.V. Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation; Associate Professor of the Department of Urology and Operative Nephrology with a course in Oncourology at the RUDN University, Moscow, Russia; RSCI Author ID: 995385; https://orcid.org/0000-0002-9676-1802
- Baitman T.P. – PhD, Researcher at the Department of Oncourology and Urology at the Vish¬nevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation; Assistant at the Department of Urology and Operative Nephrology with a course in Oncourology at the RUDN University, Moscow, Russia; RSCI Author ID: 1064032, https://orcid.org/0000-0002-3646-1664
- Oganayn V.A. – Junior Researcher at the Department of Oncourology and Urology at the Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 1133232, https://orcid.org/0000-0002-2059-8703
- Miroshkina I.V. – Junior Researcher at the Department of Oncourology and Urology at the V ishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 941028, https://orcid.org/0000-0002-5341-2100
- Borukaev A.Yu. – Junior Researcher at the Department of Oncourology and Urology at the Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 1272699; https://orcid.org/0009-0008-6626-761X
- Karelskaya N.A.– PhD, Senior Researcher, Radiologist at the Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 899039, https://orcid.org/0000-0001-8723-8916
- Kalinin D.V. – PhD, Head of the Department of Pathological Anatomy, Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 758757, https://orcid.org/0000-0001-6247-9481
- Parkhomenko D.A. – Postgraduate student at the Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; https://orcid.org/0009-0008-6460-239X
- Revishvili A.Sh. – Dr. Sci., Professor, Academician of the Russian Academy of Sciences; Director Gen¬eral of the Vishnevsky National Research Medical Center of Surgery of the Ministry of Health of the Russian Federation, Moscow, Russia; RSCI Author ID: 419879, https://orcid.org/0000-0003-1791-9163
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Introduction. The treatment of patients with venous tumor thrombi remains a challenge that requires a multidisciplinary approach. The exchange of experience between the medical centers providing medical care to such patients is extremely important for improving the results of their treatment.
The aim of the study is to analyze our own experience in treating patients with venous tumor thrombi.
Material and methods. A analysis of the treatment outcomes was performed in 120 patients (85 men and 35 women) who underwent surgery for neoplasms with venous tumor thrombi between 2012 and 2025.
Results. The average age of the patients was 67.7±9.7 years, body mass index was 27.3±4.4 kg/m2, Karnovsky index was 80.0±12.0, and Charlson comorbidity index was 7.0±2.0. At the time of cancer diagnosis, 58 (48.3%) patients had distant metastases. The most frequent localization was the lungs (53.4%). The average operation time was 298.0±111.9 min. The median blood loss was 675 [300;1350] ml. Postoperative complications developed in 29.4% of patients, 45.7% of them had grade II Clavien-Dindo complications. Most patients (82.4%) were diagnosed with clear cell renal cell carcinoma. For various reasons, 65 (54.2%) patients dropped out of the follow-up. The median follow-up of the remaining patients 55 (45.8%) was 20.5 months. Their demographic and clinical characteristics were similar to the entire study group. At the time of the analysis, 32 (58.2%) patients were alive and 23 (41.8%) had died. In the subgroup of the deceased, there was a significantly higher Charlson comorbidity index, 5.5±2.1 vs 7.5±1.6 (p=0.023), tumor size, 87.3±24.4 vs 109.2±28.9 sm (p=0.006), platelet count, 271.7±72.8 vs 389.4 ±166.9 thousand (p=0.046). Six (18.8%) of the survivors and 23 (100%) of the deceased required hemotransfusion (p=0.016). Tumor thrombus of levels 0–I was diagnosed in 59.4% of survivors and 26.1% of those who died, II–III – in 34.4% and 56.5%, IV levels – in 6.3% and 17.4%, respectively. Distant metastases were detected in 9 (28.1%) of the group of survivors and 14 (60.9%) of the deceased; pN+ status was noted in 12.5% of survivors and 26.1% of those who died. Disease progression was diagnosed in 20 (36.4%) patients. Overall survival was 20.1 months, cancer-specific survival was 21.4 months, progression-free survival was 29.7 months.
Conclusion. We have identified the following prognostic factors in venous tumor thrombi: Charlson comorbidity index, tumor size, platelet count, hemotransfusion, tumor thrombus level, presence of distant metastases, lesion of regional lymph nodes.umor thrombi.
